Mammogram Incentives – Are They Good or Bad?
By: Cohen, Placitella & Roth @ May 12, 2016
For years now, women have been encouraged to undergo regular mammograms to screen for breast cancer. Breast cancer is the most frequently-diagnosed cancer in women, but its survival rate is high if caught early enough. Although experts generally agree that regular mammograms are beneficial, there is much disagreement among them about how often testing is needed. The U.S. Preventive Services Task Force, for example, recommends that women between the ages of 50 and 74 have a mammogram every two years. The American Cancer Society, on the other hand, urges women to begin regular mammograms at 45 and continue with annual screening until age 54. After age 55, the ACS recommends mammograms every two years. Still other experts offer other guidelines.
Given this disagreement, an individual woman may be hard-pressed to know how often a mammogram is right for her. Adding extra pressure to her choice is the apparently growing practice among insurers to offer women incentives for having mammograms. These incentives can range from as little as $10 to as much as $200, in varying forms including gift cards, cash, and insurance credit. Now, a New York Times essay argues that using incentives to encourage mammograms is unethical, because it glosses over the risks and potential downsides of frequent mammograms and suggests that frequent screening is an unqualified good.
The risks of mammograms
The Times essay argues that, although regular mammograms save lives, the overall reduction in breast cancer deaths attributable to routine exams appears to be small. In addition, the essay points to the potentially serious downsides of mammography, which include false positives that can lead to unwarranted anxiety, as well as overdiagnosis and overtreatment. According to the Times essay, mammograms will detect a number of irregularities that will be classified as cancers but that, if left alone, would never ultimately have caused health problems. This problem of overdiagnosis can result in women undergoing unnecessary mastectomies, chemotherapy, and other treatments.
The Times story argues that incentivizing women to undergo mammograms is unethical because it distracts from the nuanced, individualized assessment women and their doctors should be making about the benefits and harms of mammograms. Rather, women should be rewarded for using evidence-based tools to help them decide whether and how frequently they should be having mammograms.
The benefits of incentives
Others, however, argue that because the overall practice of getting regular mammograms is widely supported, despite the controversy about how frequent screening should be, incentives should be used to encourage women to have regular mammograms. The American Cancer Society’s Vice President, quoted in a US News and World Report story, says that incentives can be helpful to get people to engage in routine preventive care they otherwise would skip – not just mammograms, but screenings for other types of cancer as well.
Reach out to our Philadelphia attorneys to learn more
If your family and medical history place you at risk for certain kinds of cancer, you are likely to need more frequent cancer screening than individuals who do not face this risk. Improper screening can lead to a failure to diagnose cancer, which can give the cancer time to spread and worsen before it finally is caught. Conversely, you may be a woman at low risk for cancer who has nonetheless been subjected to unnecessary treatment. If you believe you may have been a victim of improper cancer screening, either via failure to diagnose or an overdiagnosis, contact the skilled lawyers of Cohen, Placitella & Roth P.C. to learn more about your rights and options.