Substantial regional variation in screening costs driven by use of new, expensive technologies
WEDNESDAY, Jan. 9 (HealthDay News) -- Breast cancer screening costs the Medicare fee-for-service program more than $1 billion annually, according to a study published online Jan. 7 in JAMA Internal Medicine.
To examine the cost to fee-for-service Medicare for breast cancer screening and work-up during 2006 to 2007, Cary P. Gross, M.D., from the Yale Comprehensive Cancer Center and Yale University School of Medicine in New Haven, Conn., and colleagues used linked Surveillance, Epidemiology, and End Results-Medicare data for 137,274 women (aged 66 to 100 years) who had not had breast cancer. Screening-related costs were assessed at the Hospital Referral Region (HRR) level.
The researchers found that the annual costs for breast cancer screening-related procedures (screening plus work-up) were $1.08 billion, and treatment expenditures were $1.36 billion. Annual screening-related expenditures exceeded $410 million for women aged 75 years or older. Across regions, age-standardized screening-related cost per beneficiary varied more than two-fold (from $42 to $107); 65 percent of the difference in screening-related cost between HRRs in the highest and lowest quartiles of cost were attributed to digital screening mammography and computer-aided detection. Women were more likely to be diagnosed with early-stage cancer if they lived in HRRs with high screening costs (incidence rate ratio, 1.78). For initial cancer treatment cost per beneficiary there was no significant difference between the highest and lowest screening cost HRRs ($151 versus $115).
"Regional variation is substantial and driven by the use of newer and more expensive technologies; it is unclear whether higher screening expenditures are achieving better breast cancer outcomes," the authors write.
Several authors disclosed financial ties to the pharmaceutical and medical device industries.
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