Dense Breast Legislation and Supplemental Breast Imaging Among Women Undergoing Mammography.
Insurance coverage laws linked to higher supplemental ultrasonography use after mammography
Dense Breast Legislation and Supplemental Breast Imaging Among Women Undergoing Mammography.
To evaluate the differential association of dense breast notification and insurance coverage laws with supplemental imaging use and to assess how specific legislative features are associated with imaging use.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective, quasi-experimental cohort study used data from the MarketScan database, one of the largest national administrative claims databases in the US, from January 1, 2008, through December 31, 2019.
insurance coverage laws nearly doubled the odds of getting supplemental ultrasound
Of 12 555 082 women (mean [SD] age, 51.3 [6.9] years) undergoing mammography, 9.0% received supplemental ultrasonography and 0.6% received supplemental magnetic resonance imaging.
Notification mandates were associated with higher use of ultrasonography (odds ratio [OR], 1.09; 95% CI, 1.08-1.10) and magnetic resonance imaging (OR, 1.09; 95% CI, 1.06-1.12).
Among states with notification mandates, including information on supplemental screening (OR, 2.84; 95% CI, 2.81-2.86) and targeting notification only to women with dense breasts (OR, 1.32; 95% CI, 1.31-1.33) were both associated with higher odds of ultrasonography use.
In this cohort study of women undergoing mammography, both dense breast notification and insurance coverage laws were associated with increased use of supplemental ultrasonography, with greater odds observed for insurance mandates.
Specific legislative features, particularly targeted notification and inclusion of supplemental screening information, were also associated with increased use of supplemental ultrasonography.