As the debate rages on as to whether women should receive routine breast cancer screenings before 50, researchers have put a price tag to the practice.
Experts with Yale University and several other institutions estimated that in 2017 alone, it cost about $2.13 billion to image privately insured women ages 40-49. That’s despite fewer than half of eligible individuals in this population receiving such screenings, experts wrote in a research letter published Monday in JAMA Internal Medicine.
“These costs are borne despite the unclear tradeoff between clinical benefits and risks of screening women aged 40 through 49 years,” concluded lead author Natalia Kunst, with the department of health management and economics at the University of Oslo, Norway, and colleagues. “Of note, the costs identified in this study were substantially higher than estimates used in previous cost analyses,” the team added, noting that 2D mammography, for instance, went for about $213 a pop, compared to as low as $140 in previous studies.
To reach their conclusions, Kunst et al. analyzed data from Blue Cross Blue Shield Axis—a large database of commercial claims data. All told, the study cohort included more than 2.57 million women eligible for exams. Of those, more than 930,000 were screened using mammography (41%); 543,000-plus received 2D mammo (24%); and another 387,000 had digital breast tomosynthesis (17%). Adding to the price tag, nearly 138,000 women were recalled for diagnostic evaluation and 20,000 were referred for other diagnostic tests.
Mean cost for breast cancer screening was about $353 per beneficiary. And the main contributors to this tally were the initial screening mammography (mean of $249 per person), recall ($56) and other diagnostic tests ($45). Kunst and colleagues extrapolated their findings across the entire privately insured U.S. population to reach their $2.13 billion per-year figure, most of which was for the initial mammography screening ($1.50 billion).
The analysis also found wide regional variation in breast screening costs, ranging from $151 to $751. Debate has raged on in the medical community over the years as to whether it’s worthwhile for women to receive routine breast cancer screenings before they turn 50, with radiologists arguing that such an early intervention saves lives.
Kunst and colleagues did not editorialize on the findings, only noting that it’s another piece of the debate.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.