The Cost of Breast Cancer Screening in the United States: A Picture Is Worth ... a Billion Dollars?
Authors: Joann G. Elmore, Cary P. Gross
Journal: Annals of Internal Medicine (2014)

Editorials4 February 2014The Cost of Breast Cancer Screening in the United States: A Picture Is Worth ... a Billion Dollars?Joann G. Elmore, MD, MPH and Cary P. Gross, MDJoann G. Elmore, MD, MPHFrom University of Washington School of Medicine and School of Public Health, Seattle, Washington; and Cancer Outcomes Public Policy and Effectiveness Center, Yale School of Medicine, New Haven, Connecticut.Search for more papers by this author and Cary P. Gross, MDFrom University of Washington School of Medicine and School of Public Health, Seattle, Washington; and Cancer Outcomes Public Policy and Effectiveness Center, Yale School of Medicine, New Haven, Connecticut.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M13-2943 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Breast cancer screening has been a charged issue for decades. Concerns about access, quality, health promotion strategies, and clinical effectiveness crescendo at various times, but 1 factor is consistently overlooked: Cost. Unlike purchases outside the health care arena, there are no easily accessible price tags on screening mammography or subsequent follow-up imaging tests and procedures. Health care costs, in general, are usually obscured from view (1, 2). The absence of readily available and reliable information precludes valid assessments of costs at both the individual patient and societal levels. Women and their providers do not know the costs associated with breast ...References1. Bernstein JR, Bernstein J. Availability of consumer prices from Philadelphia area hospitals for common services: electrocardiograms vs. parking. JAMA Intern Med. 2013;:. [PMID: 24296686] MedlineGoogle Scholar2. Brook RH. Do physicians need a “shopping cart” for health care services? JAMA. 2012;307:791-2. [PMID: 22357829] CrossrefMedlineGoogle Scholar3. O'Donoghue C, Eklund M, Ozanne EM, Esserman LJ. Aggregate cost of mammography screening in the United States: comparison of current practice and advocated guidelines. Ann Intern Med. 2014;160:145-53. LinkGoogle Scholar4. Lee CI, Bassett LW, Lehman CD. Breast density legislation and opportunities for patient-centered outcomes research. Radiology. 2012;264:632-6. [PMID: 22919037] CrossrefMedlineGoogle Scholar5. Elmore JG, Fletcher SW. Overdiagnosis in breast cancer screening: time to tackle an underappreciated harm [Editorial]. Ann Intern Med. 2012;156:536-7. [PMID: 22473439] LinkGoogle Scholar6. National Cancer Institute. The Cost of Cancer. 2011. Accessed at www.cancer.gov/aboutnci/servingpeople/cancer-statistics/costofcancer on 13 December 2013. Google Scholar7. Bond M, Pavey T, Welch K, Cooper C, Garside R, Dean S, et al. Psychological consequences of false-positive screening mammograms in the UK. Evid Based Med. 2013;18:54-61. [PMID: 22859786] CrossrefMedlineGoogle Scholar8. Patient-Centered Outcomes Research Institute. Patient-Centered Outcomes Research Institute: Application Guidelines. 2012. Accessed at www.pcori.org/assets/PFAguidelines.pdf on 16 December 2013. Google Scholar9. Fox J, Zikmund-Fisher BJ, Gross CP. Older patient experiences in the mammography decision-making process [Letter]. Arch Intern Med. 2012;172:62-4. [PMID: 22232149] CrossrefMedlineGoogle Scholar10. Gross CP, Long JB, Ross JS, Abu-Khalaf MM, Wang R, Killelea BK, et al. The cost of breast cancer screening in the Medicare population. JAMA Intern Med. 2013;173:220-6. [PMID: 23303200] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Joann G. Elmore, MD, MPH; Cary P. Gross, MDAffiliations: From University of Washington School of Medicine and School of Public Health, Seattle, Washington; and Cancer Outcomes Public Policy and Effectiveness Center, Yale School of Medicine, New Haven, Connecticut.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-2943.Corresponding Author: Joann G. Elmore, MD, MPH, University of Washington School of Medicine, 325 9th Street, Box 359780, Seattle, WA 98104; e-mail, [email protected]edu.Current Author Addresses: Dr. Elmore: University of Washington School of Medicine, 325 9th Street, Box 359780, Seattle, WA 98104.Dr. Gross: Section of General Internal Medicine, PO Box 208093, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06520. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAggregate Cost of Mammography Screening in the United States: Comparison of Current Practice and Advocated Guidelines Cristina O'Donoghue , Martin Eklund , Elissa M. Ozanne , and Laura J. Esserman Aggregate Cost of Mammography Screening in the United States: Comparison of Current Practice and Advocated Guidelines Cristina O'Donoghue , Martin Eklund , Elissa M. Ozanne , and Laura J. 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