Rao Vijay M, Levin David C, Parker Laurence, Frangos Andrea J
Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA.
J Am Coll Radiol. 2008 May;5(5):652-6. doi: 10.1016/j.jacr.2008.01.023.
Recent published reports have shown a decline in the mammography screening rate in women over age 40, but it is not known whether this trend is a reason for concern in the Medicare population.
To study recent trends in mammography utilization in the Medicare population and determine how the newer digital mammography may be affecting mammography utilization.
The Centers for Medicare & Medicaid Services Physician/Supplier Procedure Summary Master Files for 1996 through 2005 were examined to determine overall trends in mammography utilization, as well as trends in screening vs diagnostic and conventional screen-film vs newer digital examinations. Medicare Limited Datasets for 2002 to 2004 were used to determine 2-year mammography and multiple imaging rates in individual patients.
Mammography utilization.
Overall, the mammography utilization rate increased from 26,646 per 100,000 in 1996 to 39,363 per 100,000 in 2005, a 48% increase. The diagnostic mammography rate decreased by 39% (from 15,314 to 9,301), whereas the rate for screening mammography increased by 166% (from 11,332 to 30,062). Digital mammography increased from 2.2% of all mammography in 2002 to 10.4% in 2005. In both digital and film mammography, screening increased more rapidly than diagnostic mammography.
The utilization rate of all mammography showed a substantial 48% increase between 1996 and 2005, and an 11% increase in screening mammography was seen between 2000 and 2005. Although the increase in mammography utilization is encouraging, the 2005 rate of 39,363 per 100,000 female Medicare beneficiaries seems to be well below American Cancer Society recommendations.
最近发表的报告显示，40岁以上女性的乳房X光检查筛查率有所下降，但尚不清楚这一趋势在医疗保险人群中是否值得担忧。
研究医疗保险人群中乳房X光检查的近期趋势，并确定更新的数字乳房X光检查如何影响乳房X光检查的利用率。
对1996年至2005年医疗保险和医疗补助服务中心的医生/供应商程序汇总主文件进行了检查，以确定乳房X光检查利用率的总体趋势，以及筛查与诊断以及传统屏-片检查与更新的数字检查的趋势。使用2002年至2004年医疗保险有限数据集来确定个体患者的两年乳房X光检查和多次成像率。
乳房X光检查利用率。
总体而言，乳房X光检查利用率从1996年的每10万人26,646例增加到2005年的每10万人39,363例，增长了48%。诊断性乳房X光检查率下降了39%（从15,314例降至9,301例），而筛查性乳房X光检查率增长了166%（从11,332例增至30,062例）。数字乳房X光检查从2002年占所有乳房X光检查的2.2%增至2005年的10.4%。在数字和屏-片乳房X光检查中，筛查的增长速度均快于诊断性乳房X光检查。
1996年至2005年期间，所有乳房X光检查的利用率大幅增长了48%，2000年至2005年期间筛查性乳房X光检查增长了11%。尽管乳房X光检查利用率的增长令人鼓舞，但2005年每10万女性医疗保险受益人的39,363例的比率似乎远低于美国癌症协会的建议。
