Congress mandated that Medicare reimburse for CAD in 2001, and most private insurers followed suit, he said, explaining the growing popularity.
Based on previous research, Fenton reported in the New England Journal of Medicine in 2007 that CAD was linked with reduced accuracy of mammogram interpretations but did not affect the detection rate of invasive breast cancer.
In the current study, Fenton's team said the costs of CAD -- about an additional $12 per mammogram -- may outweigh the potential benefits. Annually, direct costs to Medicare top $30 million, a study published last year in the Journal of the American College of Radiology found.
Dr. Carol Lee, a New York radiologist and spokesperson for the Breast Imaging Commission of the American College of Radiology, said the new study looks at CAD in real-life settings. "What this is saying is, in actual practice, when you look in the community, it doesn't seem to be living up to what earlier studies with different designs promised," she said.
But, "I don't think based on this study we should abandon the use of CAD," she added.
For one thing, it's not clear whether the radiologists were trained to use CAD correctly, she said. The authors also point this out as a possible limitation.
The trend to CAD picking up more early-stage cancers is worthwhile, she said.
Lee also said a woman is unlikely to know whether her mammogram included CAD unless she asks the doctor.
In its practice guidelines on mammography, the American College of Radiology says that CAD ''may slightly increase the sensitivity of mammographic interpretations." It also notes that CAD may be linked with increased recall of patients, some unnecessary. Under the guidelines, CAD is not considered standard of care.
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