SAN ANTONIO (AP) — Remember the uproar last year when a government task force said most women don't need annual mammograms? It turns out that only half of women over 40 had been getting them that often to start with, even when they have insurance that covers screening.
The information comes from a review of insurance
claims that show what women actually do — not what they say in surveys.
"We all support many things — fast food isn't
what we should eat for dinner every night — but that isn't what we do,"
said Dr. Milayna Subar of Medco Health Solutions Inc., which manages benefits
for many large insurers, including some Medicare plans.
She did the study, using records on more than 1.5
million women, and reported results Thursday at a breast cancer conference.
The finding is disturbing, said Dr. Judy Garber of
Dana-Farber Cancer Institute in Boston and president-elect of the American
Association for Cancer Research, one of the conference's sponsors. "Here's
an insured population where cost is not a barrier," and yet many women are
not getting tested.
Rates of screening are likely even lower among
women without insurance, though government programs pay for mammograms for many
women who lack such coverage.
Mammograms are X-rays of the breast that can reveal
tumors when they're too small to be felt. But they also raise many false
alarms, leading to worry, expense and overtreatment. How often and when women
should get mammograms has long been controversial.
In November 2009, the U.S. Preventive Services Task
Force said women in their 40s at average risk for cancer do not need mammograms
and that women 50 and older need them only every two years. Many groups,
including the American Cancer Society, still advise annual mammograms starting
at 40.
Everyone agrees that the age group that most
benefits from mammograms is women 50 to 64, and the government estimates that
roughly three-quarters of women in this age group had a mammogram within in the
previous two years, based on surveys.
However, the review of insurance claims from 2006
through 2009 put the true number at 65 percent. It also found that only 54
percent of women in this age group had been getting mammograms every year.
Among all women 40 to 85, only half had been
getting annual mammograms, the study found.
Doctors will not be surprised by these results,
said Dr. Peter Ravdin of the University of Texas Health Science Center at San
Antonio, one of the organizers of the cancer conference. Women forget or lose
track of when they last had a mammogram, and that's one of the downsides of
advice not to go every year, he said. Some may even lie when asked how often
they go.
"There's both a conscious and mostly
unconscious desire to please the person asking that question," because
most women know they should be getting one, Ravdin said.
Dr. Marisa Weiss, a 51-year-old Philadelphia breast
cancer specialist who founded the consumer Web site breastcancer.org, is glad
she had been following her own advice to get screened every year. She was
diagnosed in April with breast cancer found through a routine mammogram.
"It was a very favorable diagnosis and I feel
very lucky about that. I was a true beneficiary of early detection," she
said.
If she'd followed advice to get screened just every
two years, it could have meant "a real difference in my prognosis,"
Weiss said.
Copyright 2010 The Associated
Press.
