title: National expenditure for false-positive mammograms and breast cancer overdiagnoses estimated at $4 billion a year.
abstract: Populationwide mammography screening has been associated with a substantial rise in false-positive mammography findings and breast cancer overdiagnosis. However, there is a lack of current data on the associated costs in the United States. We present costs due to false-positive mammograms and breast cancer overdiagnoses among women ages 40-59, based on expenditure data from a major US health care insurance plan for 702,154 women in the years 2011-13. The average expenditures for each false-positive mammogram, invasive breast cancer, and ductal carcinoma in situ in the twelve months following diagnosis were $852, $51,837 and $12,369, respectively. This translates to a national cost of $4 billion each year. The costs associated with false-positive mammograms and breast cancer overdiagnoses appear to be much higher than previously documented. Screening has the potential to save lives. However, the economic impact of false-positive mammography results and breast cancer overdiagnoses must be considered in the debate about the appropriate populations for screening.
authors.affiliation: Mei-Sing Ong is a research fellow at Boston Children's Hospital, in Massachusetts, and a research fellow at the Australian Institute of Health Innovation, Macquarie University, in Sydney, Australia.
authors.forename: Mei-Sing
authors.initials: MS
authors.lastname: Ong
authors.affiliation: Kenneth D. Mandl (Kenneth_Mandl@harvard.edu) is a professor at Harvard Medical School and director of the Children's Hospital Informatics Program at Boston Children's Hospital.
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Mandl
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000191:economics; D005189:False Positive Reactions; D005260:Female; D005102:Health Expenditures; D006801:Humans; D008327:Mammography / Q000191:economics*; D008403:Mass Screening / Q000191:economics; D000069342:Medical Overuse / Q000191:economics* / Q000706:statistics & numerical data; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States
keywords: Cost of Health Care