Abstract S4-7: Compliance with Mammographic Screening Guidelines from an Administrative Claims Database

Abstract

Abstract BACKGROUND: Guidelines for breast cancer screening using mammography vary in terms of monitoring frequency and age at which screening should be performed. In November 2009, the US Preventive Services Task Force (USPSTF) modified their recommendations for women at average risk for breast cancer, now supporting first mammographic screening at age 50, with repeat mammograms every two years. The American Cancer Society and the Mayo Clinic continue to support yearly mammograms beginning at age 40. In two separate surveys performed after the USPSTF recommendations became public, 71% and 84% of women indicated an intention to undergo or continue mammographic testing during their 40's (Annals of Internal Medicine 2010; 152:531-532; USA Today 11/24/2009), but few studies have looked at actual screening frequency among women of different age groups. This study was performed to determine current pattern of testing as derived from an administrative medical claims database. METHOD: De-identified medical claims were reviewed from a 12-million member medical claims database at Medco Health Solutions, Inc. Claims for mammography for women 40 years of age and older eligible from January 2006 through December 2009 were reviewed. All women through age 64 had employer or health-plan based insurance coverage. Those 65 and older were covered through either an employer based retiree plan, or Medicare. Testing within each calendar year is reported. Annual testing was determined for women continuously eligible over the 4-year period. RESULTS: Among women 40-85 years old in any given year, 41-50% had a medical claim for a mammogram. Over the 4-year study (2006-2009), mean annual mammography rates were 41% (40-49 years old), 50.0% (50-64 years old), and 44% (65-85 years old). The percentage of women who were continuously eligible over the 4-year study period with any mammogram and with 1, 2, 3, or 4 or more mammograms over the 4-year study period are shown in the table below. CONCLUSIONS: Although surveys indicate that over 70% of women support mammographic screening between ages 40-49, these data suggest that even among an insured population, many women do not have claims evidence of even one mammogram in 4 years and almost half of women do not receive biannual or more frequent mammography. These data also indicate that additional efforts are needed to reach the HealthyPeople 2010 goal of at least 70% of women aged 40 years or older having a mammogram in the past two years. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr S4-7.