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"Compared with those who read the minimum number allowed by the Act and who have less focus on screening, physicians who focus on screening and who interpret 2,500-4,000 mammograms annually have 50 percent fewer false-positive diagnoses while detecting approximately one less cancer per 2,500 mammograms," the authors wrote.

Smith Bindman added, "The variation we found was dramatic. We recommend explicit discussion of what the goals of mammography should be, and sooner rather than later."

If the goal is to maximize the identification of cancer while achieving a reasonable false-positive rate, raising the minimum required under the Act would make sense, according to Smith-Bindman. Although fewer doctors would subsequently be available for reading mammograms, any resulting increased barriers to healthcare delivery could be managed, she said. "Change would need to occur slowly to prevent a shortage of physicians. But the payoff would be fewer false alarms for women."

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Contact: Eve Harris
eharris@pubaff.ucsf.edu
415-885-7277
University of California - San Francisco
1-Mar-2005