Older women reminded to get mammography

Older women reminded to get mammography "You have breast cancer." That's a statement about one in eight women will hear at some point in her lifetime.

Most people, even older women, are surprised to learn that a woman's risk for breast cancer continues to increase as she gets older. An 80-year-old woman has a risk of breast cancer that is 20 times higher than a 40-year-old woman.

Although mammography is the best method available to detect breast cancer early, it is underutilized by older women. Summary results of various studies indicate that only 30 percent to 60 percent of women over age 50 undergo annual or biennial mammography.

The Health Care Financing Administration (HCFA), the federal agency that administers the Medicare program, has charged all Medicare Peer Review Organizations (PROs) with the responsibility of implementing health care quality improvement projects designed to increase the use of mammography among older women. For a number of years, PROs have been working with health care providers to improve care for a variety of conditions that are common to the elderly. Now, increasing mammography utilization is one of six national priorities for all PROs. Every state and territory in the United States has a PRO. The South Dakota Foundation for Medical Care, located in Sioux Falls, is the PRO for South Dakota.

Physician recommendation plays a key role in prompting women to have mammograms. Therefore, many PROs will work to improve the frequency with which physicians recommend mammography. The South Dakota Foundation for Medical Care is currently planning an informational campaign with the South Dakota Department of Health and the American Cancer Society, South Dakota Chapter, to provide education about prevention and early detection of breast cancer through the modality of mammography.

In South Dakota, provisional data indicates that in 1997-1998, only 45 percent of female Medicare beneficiaries age 65 and older (not enrolled in an HMO) had a mammogram. The national average is 45 percent. Even though South Dakota's average is the same as the national average, many more older woman can benefit from regular use of this important screening test. Mammography can detect breast cancer early, when it is most treatable.

Women who reach age 65, on the average, live for at least 19 more years. "Given this life expectancy, it is imperative that older women have regular mammograms," said Annette E. Kussmaul, MD, MPH, the lead for HCFA's breast cancer priority.

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