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Are Pricey Computer-Aided Mammograms Worth It?
Date:4/15/2013

By Kathleen Doheny
HealthDay Reporter

MONDAY, April 15 (HealthDay News) -- Adding computer-aided detection to mammograms finds more early, noninvasive cancers and helps detect invasive cancers at earlier stages, according to a large new study. But the jury's still out as to how worthwhile the extra technology is overall.

For one thing, computer-aided detection (CAD) increases the amount of diagnostic testing among women who turn out not to have breast cancer. And the technology makes mammograms more expensive.

CAD is becoming more widespread, said Dr. Joshua Fenton, an associate professor of family and community medicine at the University of California, Davis, and lead study author. "It's an add-on and now is used in probably three-quarters of U.S. mammograms," he said.

Computer-aided detection systems use a digitized mammogram image from either a traditional film mammogram or a digitally acquired mammogram, according to the American College of Radiology. The CAD software looks for areas that may indicate cancer so the radiologist can then look more closely at the mammogram.

Although it has rapidly become part of mammogram screening, Fenton said there is limited and conflicting research on its effect.

Under Medicare payment rates, doctors get an additional $11 for adding computer-aided detection to a mammogram, said Fenton, citing Medicare data. The Medicare rate for a film mammogram is $81 while a digital mammogram is $139.

His team evaluated more than 409,000 mammograms -- with and without computer-aided detection -- from more than 163,000 women aged 67 to 89. The study is published in the April 16 issue of the Annals of Internal Medicine.

Fenton took data from a large U.S. epidemiology database from 2001 to 2006. During that time, computer-aided detection use increased from 3.6 percent to 60.5 percent. Now, with about 75 percent of mammograms adding it, it is even more common
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