New York City mammography rates for all ethnic groups ranged, on average, from 43.2% in Brooklyn to 50.3% in Manhattan. The national average was 60%; state average, 58%; and upstate average, 64.5%. For the purposes of this data release, IPRO defines upstate as outside of New York City's five boroughs and Long Island. Statistics are derived from Medicare claims and represent the most recent data available -- from October 2000 to September 2002.
"These numbers are typical of long-term trends of low mammography usage in New York City," says Clare B. Bradley MD, MPH, Senior Vice President/Chief Medical Officer, IPRO. "We believe that we should not be complacent about this situation, however, because there is clear evidence that mammography saves lives, particularly in this age group. We have been working with physicians across the state to improve their offices' performance."
IPRO's quality improvement focus includes primary care practitioners with high volume Medicare practices and low numbers of eligible patients receiving biennial mammograms. IPRO is conducting outreach and providing technical assistance to more than 1,000 physicians in 500 practices, helping them improve their systems for providing appropriate care. In addition, IPRO is providing free educational materials and offering free Continuing Medical Education (CME) credits for participation in quality-improvement activities.
"By releasing these data, we hope to help Medicare beneficiaries understand why they should not hesitate to speak with their health care providers about getting referrals for screening mammography," says Alan Silver, MD, MPH, Medical Officer, IPRO. "We also want providers to realize that they can address a large part of the performance gap by discussing the need for mammography with their patients."
Breast cancer is the second most common type of cancer among women in the United States. The American Cancer Society estimates that more than 211,000 will get breast cancer this year and 40,000 will die from the disease. As a woman ages, the chances of getting breast cancer increases. Based on a lifespan of 85 years, one in nine women is at risk of developing breast cancer. Studies have shown that screening mammograms are still the best method for early detection and that regular screening mammography can decrease the chance of dying from breast cancer.
Two new European studies provide more evidence that mammography can save lives. The studies, from Sweden and the Netherlands, show that death rates from breast cancer declined after screening mammography programs were introduced. The studies were published in the April 26 issue of The Lancet (Vol. 361, No. 9367: 1405-1410 and 1411-1417).
Medicare pays for a screening mammogram to detect cancer once a year, and also pays for diagnostic mammograms, when they are furnished by facilities that meet FDA certification requirements.
With nearly 20 years experience in health care quality evaluation, IPRO holds major contracts with state and federal governments to review the cost and quality of services provided to Medicaid recipients, Medicare beneficiaries, and patients enrolled in managed care organizations. Based in Lake Success, New York, IPRO also holds contracts with private-sector clients to improve the quality of privately financed services.
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