Mammogram Recalls Higher at Hospitals Than Private Practices: Study
Repeat tests cause anxiety and additional costs for patients
Wednesday, July 24, 2013
Recalls cause anxiety and additional costs for patients and there have been efforts to keep recall rates as low as possible, the researchers said. They added that recall rates are used by the U.S. government as a quality measure for breast cancer screening, and these findings illustrate the limitations of doing so.
The study authors analyzed data on more than 74,000 screening mammograms that were conducted at either a hospital or a private practice between May 2008 and September 2011 and reviewed by five radiologists. Both sites used the same type of mammography technology and interpretation method.
The overall recall rate was 7.8 percent, but the 6.9 percent recall rate at the community practice was much lower than the 8.6 percent recall rate at the hospital, according to the findings published online July 24 in the journal Radiology.
"For every radiologist, the recall rate was significantly lower in community practice than in the hospital setting," study author Dr. Ana Lourenco, a radiologist at the Rhode Island Hospital and the School of Medicine at Brown University, said in a journal news release.
Further analysis revealed important differences that may have affected recall rates, including the fact that many more of the hospital patients had undergone previous surgery (13 percent) and biopsies (7 percent) than the patients at the private practice, 5.6 percent and 1.4 percent, respectively.
"These patients may have more complicated mammograms to interpret or may be at higher risk for cancer than patients at the community site," Lourenco said. "Higher-risk patients would be expected to increase the recall rate of the population."
Another important factor was age. The average age of hospital patients was 56, compared with 63 for patients at the private practice.
"Younger age has been associated with higher recall rates," Lourenco explained.
She said that while efforts to develop measures of quality for breast cancer screening are commendable, recall rates can be affected by uncontrollable factors and, therefore, cannot be used alone to determine the quality of a radiologist or facility.