| | Breast Cancer Screening
Breast Cancer Screening
Purpose
To assess Gundersen Lutheran’s rate in providing recommended breast cancer screening to female patients.
Background
Breast cancer is the most common cancer among women in the United States. An estimated 192,200 women were diagnosed in 2001 with breast cancer and 40,600 women died from the disease. (1) In order to reduce deaths from breast cancer, females aged 40 and older need to adhere to screening recommendations. Gundersen Lutheran’s Preventive Care Guidelines recommend females aged 40-49 have mammography within the previous 2 years and those 50+ within the past year. In Wisconsin for 2002, 86% of women 40-49 and 73.3% of women 50+ reported having a mammogram within the recommended time. (2) In 2001, a random sample of 799 patients seen for an annual exam at Gundersen Lutheran Health System’s main campus in the departments of Family Practice, Obstetrics/Gynecology and Internal Medicine showed 73.2% compliance for women aged 40-49 and 79.3% compliance for women 50-70.
Aim
To exceed the Wisconsin benchmark for breast cancer screening in women aged 40-49 and 50-70.
Methods/measures
Female patients between the ages of 40 and 70 who were seen for an annual exam in 2002 at Gundersen Lutheran La Crosse campus, Onalaska and La Crescent sites were included in the study. Excluded were pregnant women and patients who had lab or x-ray only. For women aged 50-70, mammogram was counted if performed between 0 and 425 days prior to the exam or 60 after the exam and for women aged 40-49 was included if performed between 0 and 790 days prior to the exam or 60 days after the exam.
Benchmark
Benchmark data were obtained from Wisconsin BRFSS for the year 2000. (2) The goal of Healthy People 2010 is 70% of women aged 40 and older who have received a mammogram within the preceding 2 years.
Results
Conclusions
Rate of mammography screening from 2001 to 2002 has improved slightly among women ages 40-49 (p=0.084) and significantly among women ages 50-70 years (p<0.001). Rates are well above the Healthy People 2010 goal of 70% and above the Wisconsin average for women over age 50.
Impact
Early detection of breast cancer can prevent 16% of all deaths among women aged 40 years or older. (3) Mammography is the best available method to detect breast cancer in its earliest, more treatable stage – an average of 1 to 3 years before a women can feel a lump.
Next Steps
Continue to monitor mammography rates and educate providers on the guidelines for screening. An electronic preventive care flow sheet is being developed to provide easy retrieval of information on the date of the last procedure and prompts to remind providers of needed tests. As this flow sheet is incorporated into workflow, the rates of mammography will be monitored for effectiveness.
References
(1) US Department of Health and Human Services. HSS Affirms Value of Mammography for Detecting Breast Cancer. HHS Press Office (202) 690-6343. February 21, 2002.
www.hhs.gov/news/press/2002pres/20020221.html
(2) Centers for Disease Control, Behavioral Risk Factor Surveillance System, 2002.
http://apps.nccd.cdc.gov/brfss/age.asp?state=WI&cat=WH&yr=2000&qkey=1984&grp=0
(3) American Cancer Society, Cancer Facts and Figures 2003.
Activity Leader
Brenda Rooney, Ph.D.
Acknowledgments
Mary Gordon, RHIT and Jane Robinson, RHIA |