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Anchiy\/Getty Images<\/p>\n <\/span> \nA significant percentage of patients\u2014about 21%\u2014say that they would skip follow-up breast imaging after an abnormal mammogram if they had to pay a deductible, new research shows.\n<\/p>\n \nThe study, published on April 4 in Radiology, <\/em>asked about 700 participants if, in a hypothetical situation, they would forgo this additional imaging to confirm whether they had breast cancer.<\/span> The high percentage of people who said they would illustrates how cost is often a barrier for breast cancer screenings and diagnoses, experts said.\n<\/p>\n \n\u201cWe do know that people\u2019s decision to use health care is sensitive to the cost that they pay out of pocket for that care,\u201d Anna Sinaiko, PhD, assistant professor of health economics and policy at Harvard T.H. Chan School of Public Health, told Health<\/em>. \u201cIf you raise costs for patients, they do use less care, even when it’s needed and appropriate.\u201d\n<\/p>\n \nHere\u2019s what experts had to say about why such a significant portion of patients may be skipping breast cancer imaging, why that\u2019s cause for concern, and what to do in the face of high costs.\n<\/p>\n <\/span> <\/p>\n \nCurrently, if a person goes in to get a mammogram, it will most likely be at no cost to them. This is thanks to an Affordable Care Act (ACA) rule which requires insurance companies to provide one free mammogram annually, as they\u2019re deemed a \u201cpreventative service.\u201d<\/span>\n<\/p>\n \nBut if a person gets their mammogram results back and their health care provider spots something abnormal, they\u2019ll be called for additional imaging. This is where things can get expensive.\n<\/p>\n \n\u201cOnce they find something and they want you to come back and get an additional imaging exam, that might be mammogram, but often it\u2019s ultrasound or MRI or some other kind of imaging. Then that no longer is called a screening test,\u201d Karen Kuntz, ScD, professor of health policy and management at the University of Minnesota School of Public Health, told Health<\/em>. \u201cIt\u2019s a diagnostic test. And so now that can trigger a co-payment.\u201d\n<\/p>\n \nHoping to investigate the effect of these additional imaging costs, researchers gave a survey to patients at Boston Medical Center between September 2021 and February 2022.<\/span>\n<\/p>\n \nThere were 714 people who answered the survey question, \u201cIf I knew that I had to pay a deductible for the additional imaging [to make sure my screening mammogram is normal], I would skip this additional imaging.\u201d About 21% of the respondents said that they would, and nearly 60% said they wouldn\u2019t consider skipping the follow-up imaging.<\/span>\n<\/p>\n \nAdditionally, 707 participants answered a question on whether they would skip breast cancer screening altogether if they knew that they\u2019d have to pay a deductible for follow-up tests later on. About 18% said they would skip this initial screening mammography, while about 66% said they would not.<\/span>\n<\/p>\n \nBesides those who gave a yes or no to each hypothetical statement, a significant portion of people said they weren\u2019t sure what they would do\u2014another 20% said they were undecided on whether they would skip a follow-up imaging after an abnormal mammogram, and 16% said they didn\u2019t know if they would skip initial mammography.<\/span>\n<\/p>\n \nThis could indicate that the actual number of people who end up avoiding these follow-up tests and screenings is even higher.\n<\/p>\n \nThe study also found that certain demographic groups were more likely to skip breast imaging than others. In line with pre-existing health disparities, people who were less-educated, had a lower income, were not white, and had Medicaid or no insurance were most likely to avoid both mammography and additional breast imaging due to cost.<\/span>\n<\/p>\n \n\u201cIt\u2019s going to increase disparities in breast cancer outcomes, which is what we don\u2019t want,\u201d Kuntz said.\n<\/p>\n \nThe study does have a few limitations, experts explained. Since there were only a few hundred participants, the results may not reflect the sentiments of the entire U.S. population who are eligible for mammograms. Also, the researchers asked patients to explain their behavior in a hypothetical situation, which could mean they\u2019d act differently when faced with an actual abnormal mammogram and high deductible.\n<\/p>\n \nStill, the study\u2019s findings seem to be in line with what researchers already know. A study published last year found that about 20% of people did not return for their follow-up examination after receiving inconclusive mammogram results.<\/span> And the problem is apparent outside of breast cancer screening, too\u2014about 40% of survey respondents reported skipping a recommended medical test or treatment because they were worried about cost.<\/span>\n<\/p>\n Nearly 50% of Women Skip Preventative Health Appointments\u2014Here Are the Checkups to Prioritize<\/span><\/p>\n <\/span> <\/p>\n \nReceiving abnormal mammogram results is fairly common, said Therese Bevers, MD, medical director of the Cancer Prevention Center at the University of Texas MD Anderson Cancer Center. But it\u2019s always better to be safe.\n<\/p>\n \n\u201cWhile 80% [of abnormal mammograms] are not<\/em> breast cancer, 20% are,\u201d Dr. Bevers told Health<\/em>. \u201cWhere do the two intersect? How\u00a0many of the 20% of breast cancers are going to be in that one of five women who elect to not get the further workup? And so then things progress, and she\u2019s ultimately diagnosed at a more advanced stage.\u201d\n<\/p>\n \nThis is precisely what healthcare providers are trying to avoid, Sinaiko explained.\n<\/p>\n \n\u201cCancer outcomes are a lot better the earlier it is detected,\u201d she said. \u201cWe want patients to go for their mammograms to be screened so that we can catch the disease as early as possible, then it just leads to better survival and quality of life.\u201d\n<\/p>\n \nThe findings are also concerning because they raise the question of whether skipping care is common practice even after people get diagnosed with breast cancer, said Sarah Tevis, MD, assistant professor of surgery at the University of Colorado Anschutz Medical Campus.\n<\/p>\n \n\u201cIf it\u2019s such a barrier that they can\u2019t even get [screened] to get diagnosed, are they going to be able to afford to follow through with the treatment recommendations that we provide?\u201d she told Health.<\/em>\n<\/p>\n MRIs May Detect Cancer in Dense Breasts Better Than Mammograms\u2014Should You Get One?<\/span><\/p>\n <\/span> <\/p>\n \nThough it\u2019s important for people to commit to additional breast cancer imaging if necessary, it can be hard to quantify the cost. For one, the cost often depends on the type of imaging a provider orders, the experts said.\n<\/p>\n \n\u201cThey could maybe just need a diagnostic mammogram that reassures the radiologist that there\u2019s nothing concerning going on,\u201d Dr. Tevis said. \u201cOr they could need a mammogram and an ultrasound and a biopsy and an MRI.\u201d\n<\/p>\n \nIf more intensive exams are required, she explained, that\u2019s where the costs could become quite significant.\n<\/p>\n \nWhat the patient themselves is responsible for paying also depends on if they have health insurance, and the type that they have.\n<\/p>\n \nIf the additional breast imaging falls under someone\u2019s deductible, Sinaiko explained, they will have to pay the full cost. It may be less expensive if a person has a copay or coinsurance, where they\u2019ll pay a flat fee or a percentage of the cost, respectively.\n<\/p>\n \nIn addition to the cost of the care itself, patients may be discouraged from going to their follow-up if they have to find childcare, travel long distances, or take time off work, Dr. Tevis added.\n<\/p>\n \n\u201cAs you start to think about the different financial barriers to getting that further workup, you can see why some women may find that prohibitive,\u201d Dr. Tevis said. \u201cI\u2019ve seen women who don\u2019t have insurance and who can\u2019t afford their screening exams who have come in with a breast cancer diagnosis that probably would have been picked up on a screening mammogram.\u201d\n<\/p>\n \nLowering costs may be a matter of simply redefining what is considered a preventative screening test versus a diagnostic test. If follow-up appointments were considered the former rather than the latter, public and private insurance would likely cover them.\n<\/p>\n \n\u201cThe intent of the screening mammogram is early detection,\u201d Dr. Bevers said. \u201cJust getting the screening mammogram isn\u2019t enough. You\u2019ve got to complete the workup. And so the workup really is part of the screening.\u201d\n<\/p>\n \nCovering preventative care is also to the benefit of groups such as insurance companies and employers, Sinaiko added, since it increases the odds that someone will need less aggressive care down the road if their cancer is caught early.\n<\/p>\n \nBut for now, experts agree that people should make a plan for what they should do if they were to need a follow-up breast exam. They can call and ask their insurance provider to spell out what exactly is covered, Kuntz said, and they may want to consider shopping around to see if they can find better coverage for these follow-up tests, Sinaiko added. Healthcare facilities may also have financial counselors or other resources that people can take advantage of, Dr. Tevis said.\n<\/p>\n \nBeyond the individual level, however, real change in the costs associated with follow-up breast imaging may need to come from a higher level. This could include everything from legislative pressures on insurance companies, to raising awareness of the importance of attending these types of appointments, experts agree.\n<\/p>\n \nCovering that initial screening mammography is a huge step in the right direction, but patients need to be in a position where they can actually determine whether they have breast cancer.\n<\/p>\n \n\u201cPeople are becoming more and more aware that, \u2018Oh, this is great that we\u2019re covering the screening tests, but we have to cover all of the follow-up tests as well,\u2019\u201d Kuntz said. \u201cOtherwise, there\u2019s no effectiveness\u2014[there\u2019s] no upside to doing that first test if you can\u2019t do the follow-up.\u201d\n<\/p>\n How To Fight Medical Bills<\/span><\/p>\n","protected":false},"excerpt":{"rendered":" About 1 in 5 patients surveyed said that if they received abnormal mammogram results, they would not go in for follow-up imaging if they had to pay a deductible. Most abnormal mammograms are false positives, experts said, but additional follow-up imaging tests are necessary to determine if someone has early-stage breast cancer. These high deductibles […]<\/p>\n","protected":false},"author":2,"featured_media":17140,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[410,801],"tags":[116,802],"_links":{"self":[{"href":"https:\/\/1millionbestdownloads.com\/wp-json\/wp\/v2\/posts\/17140"}],"collection":[{"href":"https:\/\/1millionbestdownloads.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1millionbestdownloads.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1millionbestdownloads.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1millionbestdownloads.com\/wp-json\/wp\/v2\/comments?post=17140"}],"version-history":[{"count":0,"href":"https:\/\/1millionbestdownloads.com\/wp-json\/wp\/v2\/posts\/17140\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/1millionbestdownloads.com\/wp-json\/wp\/v2\/posts\/17140"}],"wp:attachment":[{"href":"https:\/\/1millionbestdownloads.com\/wp-json\/wp\/v2\/media?parent=17140"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1millionbestdownloads.com\/wp-json\/wp\/v2\/categories?post=17140"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1millionbestdownloads.com\/wp-json\/wp\/v2\/tags?post=17140"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\n<\/figcaption><\/figure>\n Additional Costs Deter People From Seeking Breast Cancer Imaging\u00a0 <\/span> <\/h2>\n
The Importance of Follow-Up Imaging for Early Detection <\/span> <\/h2>\n
What People Can Do to Get Their Breast Imaging Costs Down <\/span> <\/h2>\n