Higher Mammography Screening Costs Without Appreciable Clinical Benefit: The Case of Digital Mammography
Menée aux Etats-Unis à partir des données des registres des cancers portant sur deux cohortes incluant respectivement 137 150 et 133 097 femmes bénéficiant du système d'assurance Medicare (âge moyen pour la première cohorte : 76 ans ; âge moyen pour la deuxième cohorte : 77,3 ans), cette étude évalue l'évolution de l'utilisation et du coût de la mammographie de dépistage du cancer du sein sur la période 2001-2009 ainsi que l'évolution de l'incidence de la maladie et du stade au diagnostic
Low sensitivity of film-screen mammography in women aged 40 to 49 years paved the way for digital mammography (1), which improves screening sensitivity relative to film-screen mammography in women with dense breasts, pre- and perimenopausal women, and those aged 40 to 49 years (2,3). Digital mammography now accounts for 94% of mammography units in the U.S. (4). New evidence reported in this issue of the Journal describes the diffusion and annual cost of digital mammography in the Medicare population. Killelea et al. describe the rapid increase in digital mammography use from 2.0% in 2001–2002 to 29.8% in 2008–2009 (5). Transition to digital mammography increased Medicare screen-related costs from $666 million to $962 million with most cost increase due to the higher cost of digital than film-screening mammography and uptake of computer-aided detection (CAD)...
Journal of the National Cancer Institute , éditorial en libre accès, 2014