The Effect of the Controversial US Preventive Services Task Force Recommendations on the Use of Screening Mammography

Purpose: The 2009 release of updated US Preventive Services Task Force (USPSTF) recommendations on screening mammography differed sharply from those of the American Cancer Society, the ACR, and the American College of Obstetricians and Gynecologists. The aim of this study was to ascertain the effect of these recommendations on the utilization of screening mammography in the Medicare population. Methods: The Medicare Part B Physician/Supplier Procedure Summary Master Files from 2005 through 2010 were used to determine the annual utilization rate of screening mammography from 2005 to 2010. A utilization trend line was plotted for those years. Results: The utilization rate of screening mammography per 1,000 women in the Medicare population was 311.6 in 2005 and increased gradually each year to 322.9 in 2009 (a compound annual growth rate of 0.9%). However, after the USPSTF recommendations were issued in late 2009, this rate decreased abruptly to 309.1 (-4.3%) in 2010. Conclusions: The abrupt decrease in the utilization of screening mammography in 2010 was in sharp contrast to the previous slow annual increases in its utilization from 2005 to 2009. Because there are no other factors to explain a decrease of this magnitude, it would seem that the USPSTF recommendations and the ensuing publicity resulted in a decrease in the utilization of screening mammography in the Medicare population in the first year after issuance of the new recommendations.