MONDAY, April 29 (HealthDayNews)-- The value of mammograms has been the subject of a seesaw battle in the medical world recently.
What no one is contesting, however, is that some cancers are missed in mammograms. When this happens, whether due to malpractice or the limitations of the technology, lawsuits often result.
Even more troubling, the cost of such lawsuits could exceed $250 million in the next 10 years, says a new analysis presented today at the American Roentgen Ray Society's annual meeting in Atlanta.
"This is going to be a huge public health problem," says study author Dr. Richard Tello, a professor of radiology, epidemiology and biostatistics at Boston University.
Every year, almost 200,000 women in this country are diagnosed with breast cancer and more than 40,000 die from the disease, according to the Centers for Disease Control and Prevention (CDC). The agency also reports that two-thirds of women over 40 have had a mammogram in the past two years. More are expected as more baby boomers reach the age at which they should get mammograms.
The General Accounting Office, citing U.S. Census statistics, reported last week that the number of women who will need mammograms is expected to increase by more than 1 million a year. The report, prepared amid concerns that the rising number of eligible women may lead to long waits to get the procedure, adds "the nation's overall capacity to provide mammography services is generally adequate to meet the growing demand."
Tello says he and his colleagues assumed only one in 10 people who could sue would actually do so. Based on 1995 figures, the average settlement figure would be about $200,000, he says.
Using these figures, which he calls conservative, Tello says it would cost $70 for every mammogram done today simply to cover future litigation costs. If they had used less conservative figures, he says the cost could be as high as $200 for every mammogram done today.
If nothing is done to address this problem, insurance premiums will likely rise, malpractice insurance will go up, and it may become too expensive for many centers to continue doing mammography, Tello says.
He suggests creating a centralized, no-fault insurance pool to cover these future costs, though he isn't exactly sure how it would be funded. Clear cases of malpractice would still go through the court system, Tello says.
"The leading cause for malpractice claims is failure to diagnose breast cancer on a mammogram. As the number [of women screened] increases, the number of lawsuits will necessarily go up," says Barbara Brenner, executive director of Breast Cancer Action, a breast cancer advocacy group in San Francisco.
A big part of the problem, she says, is women have been misled about what mammography can and can't do. "Unless people understand that it's not foolproof, that it cannot find all cancer, there's going to be a problem. It's a limitation in the technology, not necessarily negligence," she says.
While she says a no-fault insurance system makes some sense, Brenner says she'd rather see money put into research on new treatments.
Spending a lot of time avoiding legal action is "not going to help women at the end of the day. We should be pushing for better answers," she says.
What To Do: To learn more about breast cancer and mammograms, go to the National Cancer Institute. For information on mammogram screening guidelines or on places to get a low-cost mammogram, go to the Centers for Disease Control and Prevention.
