Center for Research on Utilization of Imaging Services, Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Philadelphia, PA 19107, USA.
J Am Coll Radiol. 2013 Jan;10(1):21-4. doi: 10.1016/j.jacr.2012.07.008.
The 2009 release of updated US Preventive Services Task Force (USPSTF) recommendations on screening mammography differed sharply from those of the American Cancer Society, the ACR, and the American College of Obstetricians and Gynecologists. The aim of this study was to ascertain the effect of these recommendations on the utilization of screening mammography in the Medicare population.
The Medicare Part B Physician/Supplier Procedure Summary Master Files from 2005 through 2010 were used to determine the annual utilization rate of screening mammography from 2005 to 2010. A utilization trend line was plotted for those years.
The utilization rate of screening mammography per 1,000 women in the Medicare population was 311.6 in 2005 and increased gradually each year to 322.9 in 2009 (a compound annual growth rate of 0.9%). However, after the USPSTF recommendations were issued in late 2009, this rate decreased abruptly to 309.1 (-4.3%) in 2010.
The abrupt decrease in the utilization of screening mammography in 2010 was in sharp contrast to the previous slow annual increases in its utilization from 2005 to 2009. Because there are no other factors to explain a decrease of this magnitude, it would seem that the USPSTF recommendations and the ensuing publicity resulted in a decrease in the utilization of screening mammography in the Medicare population in the first year after issuance of the new recommendations.
2009 年发布的美国预防服务工作组（USPSTF）更新版筛查乳房 X 线摄影建议与美国癌症协会、ACR 和美国妇产科医师学会的建议大相径庭。本研究旨在确定这些建议对医疗保险人群中筛查乳房 X 线摄影利用率的影响。
使用 2005 年至 2010 年医疗保险 B 部分医生/供应商程序汇总主文件，确定 2005 年至 2010 年筛查乳房 X 线摄影的年度利用率。绘制了这些年份的利用率趋势线。
医疗保险人群中每 1000 名女性的筛查乳房 X 线摄影利用率在 2005 年为 311.6，每年逐渐增加，至 2009 年达到 322.9（复合年增长率为 0.9%）。然而，在 2009 年底 USPSTF 建议发布后，这一比率在 2010 年突然降至 309.1（-4.3%）。
与 2005 年至 2009 年筛查乳房 X 线摄影利用率缓慢逐年增加形成鲜明对比的是，2010 年其利用率突然下降。由于没有其他因素可以解释这种程度的下降，似乎 USPSTF 建议及其随之而来的宣传导致新建议发布后的第一年医疗保险人群中筛查乳房 X 线摄影利用率下降。
