Mammo false positives, overdiagnosis cost U.S. $4B per year

Mammo false positives, overdiagnosis cost U.S. $4B per year By Kate Madden Yee, AuntMinnie.com staff writer April 7, 2015 — False positives and overdiagnosis related to mammography screening cost the U.S. $4 billion per year, a figure that’s much higher than previous estimates, according to a study published in Health Affairs. But the study’s findings are based on previous research that has already been criticized by advocates of screening. Researchers Mei-Sing Ong, PhD, and colleague Dr. Kenneth Mandl from Boston Children’s Hospital used data taken from two controversial papers to assess costs associated with false-positive mammograms and overdiagnosis of screen-detected breast cancer in women between the ages of 40 and 49. The study included data from 702,154 female beneficiaries of a major U.S. healthcare insurer who had routine mammography screening in 2012 and who were continuously enrolled in the health plan for a year following the initial screening mammogram (Health Affairs, April 6, 2015). Ong and Mandl evaluated two mammography screening outcomes: false-positive mammograms, which they defined as exams that led to further diagnostic workup (more mammography or a biopsy) but did not result in a breast cancer diagnosis, and screen-detected breast cancer. The researchers conceded that they could not distinguish which cancers were overdiagnosed from the actual patient data they analyzed, so they extrapolated the data using figures taken from recent studies. The researchers evaluated the use of medical services related to breast cancer in the 12 months after the initial screening exam: mammography screening, diagnostic mammography, other imaging exams, chemotherapy, radiation therapy, pathology, outpatient consults, inpatient services, anesthesia, and medications. They defined costs as the total amount paid by the insurer —...