Doctors Not Recommending Mammograms for Medicaid Patients

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A study found that only about half of people who received health care through the North Carolina Medicaid program had proper screenings for colorectal, breast, and cervical cancer. In most cases, people weren't screened because doctors weren't suggesting screening tests as recommended by national guidelines.

Only 60% of women in the study who should have had a mammogram actually were sent for a mammogram. Overall, only about 32% of the women had a mammogram within 2 years, whether or not it was recommended.

Researchers reviewed the medical records of nearly 2,000 people age 50 or older who had seen their primary care doctor during a 6-month period in 2006. Since all of the women were 50 or older, all of them should have had a mammogram done within 2 years.

The researchers aren't sure why doctors in this study didn't recommend mammograms as they should. It's also not clear why most of the women didn't get mammograms as they should, even when a mammogram was recommended by a doctor.

Other research has shown that disparities in breast cancer screening and care can be related to factors such as age, race, economic and educational status, access to consistent primary health care, and insurance coverage. In this study, all of the Medicaid patients had consistent access to primary care and mammograms were fully covered. Some other research has shown that African American women are less likely than white women to get recommended mammograms. But in this study, African American women were more likely than white women to get a mammogram.

A long-standing relationship with a primary care doctor strongly influenced the likelihood that people in the study would get cancer screenings as they should. People who saw the same primary care doctor for 5 or more years were about 2.5 times more likely to get recommended cancer screenings compared to people who saw the same primary care doctor for fewer than 2 years. Other research has shown that people get better care when they have a "medical home" -- a primary care doctor or group of doctors who oversee all medical care over a long period of time.

No matter your personal circumstances, skipping regular mammograms is NOT an option if you're older than 40. Stick with the mammogram screening plan you and your doctor decide is best for you. If your doctor doesn't talk about screening or send you for a mammogram, speak up and ask for the referral you need.

  • If you're worried about the cost because you don't have insurance, talk to someone -- your doctor, a local hospital social worker, or staff members at a mammogram center -- who can help you. Ask about free mammogram programs in your area.
  • If you're having problems scheduling a mammogram, ask for help. You can call the National Cancer Institute (800-4-CANCER) or the American College of Radiology (800-227-5463) to find certified mammogram providers near you.
  • If mammograms are painful for you, ask the mammography center staff members how the experience can be as easy and as comfortable as possible.
  • In between mammograms, remember to perform regular breast self-exams. Tell your doctor right away if you find anything you're concerned about. If you need information about how to do a self-exam, ask your doctor.

There's only one of YOU and you deserve the best care possible -- including regular mammograms.

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