Study Finds Unnecessary Mammograms Performed On Elderly Women With Dementia

Main Category: Seniors / Aging
Also Included In: Women's Health / Gynecology;  Alzheimer's / Dementia;  Breast Cancer
Article Date: 22 Jan 2010 - 5:00 PDT

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A new study in the American Journal of Public Health found that 18% of elderly women with severe dementia undergo screening mammograms, despite guidelines from the American Cancer Society and other groups that recommended against such screening for women with a life expectancy of less than five years, Newsweek reports. Elderly women with dementia have an average life expectancy of 3.3 years, according to Newsweek.

The study examined more than 2,000 women older than age 70. Evidence-based guidelines state that any cancer found in screenings in this age group likely would not grow fast enough to reduce a patient's lifespan in women expected to live fewer than five years. The study found that 45% of women with normal cognitive status underwent screening mammograms, which "seems about right" because these women are more likely to be in good health and expected to live more than five years, according to Newsweek.

Mammograms can lead to follow-up tests, such as biopsies, and unnecessary surgeries for growths that would never become problematic. According to Newsweek, women with dementia might not understand why they are being tested, and mammograms and follow up "divert time and focus away from the medical care that makes much more difference to someone with severe dementia." Study author Kala Mehta, a geriatrics researcher at University of California-San Francisco, said, "The potential harms are likely to outweigh the benefits." If the study's results are accurate, then more than 120,000 mammograms are performed on elderly, severely cognitively impaired women every year in the U.S., at a cost exceeding $12 million.

The study also found that 47% of elderly women with severe cognitive impairment who are married and have a net worth of at least $100,000 received mammograms. Newsweek reports that this figure may reflect the actions of well-intentioned husbands who keep taking their wives for screening, not knowing that it is unlikely to be of any benefit and could actually hurt them. The money connection is less clear because doctors who accept Medicare patients agree to accept that reimbursement as full payment. Those who do not may be more likely to recommend screening if the woman can pay out of pocket or has private, supplemental insurance(Begley, Newsweek, 1/19).

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