Evidence map›Paper›PMID 40987968›Full record

ArticleJournal of general internal medicine2026

Changes in Use, Cost, and Value of Breast Cancer Screening Among Older Women in the US.

Ilana Richman, Jessica B Long, Meghan E Lindsay, A Mark Fendrick, Kelly Kyanko, Cary P Gross

Abstract read
In one paragraph

Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ilana RichmanSection of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA. ilana.richman@yale.edu.ORCID 0000-0001-7438-8907
Jessica B LongSection of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
Meghan E LindsaySection of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
A Mark FendrickDepartment of Internal Medicine and Department of Health Management and Policy, Division of General Medicine, University of Michigan, Ann Arbor, MI, USA.
Kelly KyankoDepartment of Population Health, NYU Grossman School of Medicine, New York, NY, USA.
Cary P GrossSection of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA.

Funding

NCI NIH HHS CA 248725
6 · The paper itself

Abstract

backgroundThe clinical and economic impact of breast cancer screening varies based on the modality, frequency, and age of the screened population.

objectiveTo characterize changes in use and cost of breast cancer screening for older women.

designSerial cross-sectional study using data from SEER-Medicare, 2009-2019.

participantsWomen 67 and older enrolled in Medicare fee-for-service. MAIN MEASURES: Screening use and cost by age, frequency, and modality. We further categorized screening as cost-effective or cost-ineffective based on published economic analyses rather than guidelines. Cost-effective screening included biennial mammography among women < age 80, while cost-ineffective screening included annual mammography, addition of digital breast tomosynthesis (DBT), screening ultrasound, and any screening among women 80 and older. We estimated total annual spending on screening in Medicare fee-for-service, inflated to 2019 dollars. KEY

resultsOur sample included a mean of 229,683 (range 222,400- 244,793) Medicare beneficiaries annually. Biennial screening was stable among women 65-79, at 11.2% (95% CI 11.0-11.4) in 2009 and 11.9% (95% CI 11.7-12.0) in 2019. Annual screening was also stable at 32.5% (95% CI 32.3-32.7) in 2009 and 30.0% (95% CI 29.8-30.2) in 2019. Among women 80 and older, screening (annual or biennial) declined from 19% (95% CI 18.8-19.3) to 12.9% (95% CI 12.7-13.2). Between 2009-2019, use of DBT rose from 0% to 70.3% of screened women. Total spending on cost-effective screening rose from $569 million per year to $735 million per year, a 29% increase. Spending on cost-ineffective screening rose from $548 million to $1.025 billion, an 87% increase. By 2019, spending on cost-ineffective screening accounted for 58% of total spending.

conclusionsScreening costs for older women have risen, driven by expenditures on technologies that may not be cost-effective. Reducing use of low value screening could result in savings that could be reallocated toward high value screening and follow up testing.

Indexed as

Breast NeoplasmsEarly Detection of CancerMammographyMass ScreeningAgedAged, 80 and overCost-Benefit AnalysisCost-Effectiveness AnalysisCross-Sectional StudiesFee-for-Service PlansFemaleHumansMedicareSEER ProgramUnited States

Identifiers

PMID40987968
PMCPMC13241555

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.