October is breast cancer awareness month, making it the perfect time to focus on increasing the rate of mammograms for women ages 50-74.
By June 30, 2020, 41 percent of U.S. adults had delayed or avoided medical care. This is a story I know all too well – as I am one of those adults, over 50 and who has put off mammography and colonoscopy screening due to COVID. Despite being a strong believer in the value of preventive medicine and understanding the consequences for failing to be proactive in my health, I let space and ultimately inertia get in the way. It is only through the writing of this blog, not the ceaseless reminders from my physician’s practice or my health plan, that I finally “got off the dime” and scheduled my annual physical to arrange for my screening backlog.
Because of people like me and the overwhelming national statistics, Dr. Norman E. Sharpless, director of the National Cancer Institute, predicted, “The lack of screenings and treatments could result in almost 10,000 excess deaths from breast and colorectal cancer in the next decade.” This is an increase of roughly one percent from these two tumor types, which together account for about one-sixth of all cancer deaths.
It’s too early to know if Dr. Sharpless will be right, but there is some evidence that more advanced, aggressive breast cancers have been diagnosed during the COVID-19 pandemic. Data from the Kaiser Permanente Northern California healthcare systems comparing the diagnosis of breast cancers during the pandemic to the previous year shows a higher rate of symptomatic disease as well as T1C tumors and triple-negative disease in 2020.
Without a doubt, the pandemic has reinforced an existing tenet of cancer treatment – screening is critical to early detection and treatment.
According to breastcancer.org, breast cancer is the most commonly diagnosed cancer among American women. Approximately one in eight U.S. women will develop invasive breast cancer in her lifetime. In 2021, nearly one third of newly diagnosed cancers in women will be breast cancer. This year, about 43,600 women in the U.S. are expected to die from breast cancer.
HEDIS® Breast Cancer Screening Rates
That’s why the breast cancer screening rate – that is, the percent of women 50-74 years of age who had at least one mammogram to screen for breast cancer in the past two years – is a critical and longstanding HEDIS® measure of health plans. Likewise, employers want to know what their health plan is doing to encourage mammograms. Pre-pandemic HEDIS® rates topped out at nearly 74 percent, indicating there’s more health plans can do to boost mammogram rates.
Health plans are increasingly looking to analytics to work collaboratively with providers in their network to identify women whose mammograms are already overdue or are due in the next three months. This data helps both health plans and providers to:
- Evaluate measures such as mammography against industry or contract targets at the provider level.
- Identify cohorts of patients who have open gaps in care.
- Outreach to members, one to many times, to schedule primary care visits and referrals to specialty practices to close gaps in care.
Data and information are just the first step, albeit an important one, to ensuring women get their screenings. Often it takes multiple rounds of outreach, from the health plan and the provider, to get the message across. And sometimes, it takes outside reinforcement, like writing a blog, to get the laggards like myself “off the dime”.