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Utilization and Cost of Mammography Screening Among Commercially Insured Women Aged 50 to 64 Years in the United States, 2012-2016
  • Published Date:
    October 15 2019
  • Source:
    J Womens Health (Larchmt). 29(3):327-337
  • Language:

Public Access Version Available on: September 01, 2020, 12:00 AM information icon
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  • Alternative Title:
    J Womens Health (Larchmt)
  • Description:
    Background: In recent years, most insurance plans eliminated cost-sharing for breast cancer screening, recommended screening intervals changed, and newer modalities—digital mammography and breast tomosynthesis—became more widely available. The objectives of this study are to examine how these changes affected utilization, frequency, and costs of breast cancer screening among commercially insured women, and to understand factors associated with utilization and frequency of screening. Methods: This study used commercial insurance claims data for women aged 50 to 64 years continuously enrolled in commercial insurance plans during 2012–2016. Results: Of the 685,737 eligible women, 20% were not screened, 40% received annual screening, 24% received biennial screening, and 16% were screened less frequently than recommended during the time period examined. Sociodemographic factors such as age <60 years, rurality, and fee-for-service insurance were associated with low screening utilization. Patients who received annual screening incurred approximately 1.78 times higher costs as compared to those who received biennial screening during the study period. Digital mammography was the most costly and commonly used modality along with computer-aided detection. Conclusions: Evidence-based interventions to promote screening among women who are screened less frequently are needed along with interventions to move toward biennial screening rather than annual screening. Increasing provider awareness regarding breast cancer screening rates and frequency among various sociodemographic groups is essential to guide provider recommendations and shared decision making. The results of this study can guide targeted public health interventions to reduce barriers to screening, and can also serve as inputs for economic analyses of screening interventions and programs.
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