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Digital mammography more cost-effective for younger women under 50
A cost-effectiveness study of digital and film screening mammography showed that digital mammography does not result in sufficient health gains to warrant its increased cost unless its use is limited to younger women under the age of 50.
Dec. 31, 2007
Digital mammography more cost-effective for younger women under 50
A cost-effectiveness study of digital and film screening mammography showed that digital mammography does not result in sufficient health gains to warrant its increased cost unless its use is limited to younger women under the age of 50.
Scientists with the Digital Mammography Imaging Screening Trial (DMIST), a part of the American College of Radiology Imaging Network, published their findings in the January 1 issue of the Annals of Internal Medicine.
DMIST had previously shown that digital mammography benefits women under the age of 50 and those with dense breasts. Results of this follow-up study suggest no clear benefit for digital mammography in the elderly.
These results also provide a hint that elderly women with non-dense breasts may have better breast cancer detection with film rather than digital mammography. However, the original study showed equivalent diagnostic accuracy for digital and film mammography overall, and the current study does not contradict those results. The study involved more than 42,000 women in Canada and the United States.
Dr. Etta Pisano, principal investigator of DMIST, said,” These results mean that insurers should reimburse for screening with digital mammography for women under age 50. Reimbursement for digital mammography screening for older women will be more controversial. “
Pisano is vice dean for academic affairs at the University of North Carolina School of Medicine and director of the Biomedical Research Imaging Center. She is also a member of UNC Lineberger Comprehensive Cancer Center.
She explained, “However, given that most radiology departments are all digital otherwise, there are good reasons why departments will want to convert to digital mammography completely, and not retain two systems, one for older women and one for younger women. So, payers are likely to end up reimbursing for digital mammography for all women, not because it is cost-effective in all groups, but because it is equivalently accurate and available.”
Other study authors are from Norris Cotton Cancer Center, Lebanon, N.H.; Harvard School of Public Health, Boston, Mass.; University of Wisconsin Comprehensive Cancer Center, Madison, Wisc.; Brown University, Providence R.I. The study was funded by the National Cancer Institute.
Dr. Pisano will be available for interviews on Dec. 31, 2007 and Jan. 2, 2008. To request an interview, please call Dianne Shaw or Tom Hughes.
Lineberger Cancer Center contact: Dianne Shaw, (919) 923-6012 or dgs@med.unc.edu
School of Medicine contact: Tom Hughes, (919) 966-6047 or TAHughes@unch.unc.edu
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