Accreditation of mammography facilities by the American College of Radiology: results of a national survey.

Mammographic screening for the early detection of breast cancer is rapidly becoming an increasingly common practice in the United States. With more than 20 million mammograms estimated to be performed annually by more than 11,000 units, ongoing quality assurance and evaluative programs have gained importance. Recent federal legislative and regulatory efforts augment a patchwork of state mandates establishing or encouraging specific quality control requirements for mammography facilities, personnel, equipment, and radiation exposure. Many of these requirements are based on the American College of Radiology's (ACR) voluntary accreditation program that has been offering facility certification since 1987. The ACR collects and maintains detailed data on the characteristics of accredited facilities; however, little is known about facilities not participating in the ACR program. This article describes national results from the 1992 National Mammography Facilities Survey, a representative sample of 1,057 mammography facilities. We found statistically significant (P < .05) differences between accredited and nonaccredited facilities in type of mammography practices, cost, personnel standards, variables linked to accessibility, and corollary screening practices (availability of breast self-examination instruction and breast physical examination). Other variables showed minor or little variation between accredited and nonaccredited facilities. The results of this study suggest that, although all facilities engage in various components of "good" quality assurance practices, ACR-accredited facilities reported conducting these programs more frequently. Further, despite the substantially increased costs associated with these programs, ACR-accredited facilities reported lower average charges for screening mammograms and were more likely to participate in reduced fee programs.