Percentage of female Medicare enrollees ages 65-74 that received an annual mammography screening. The 2023 County Health Rankings used data from 2020 for this measure.
Evidence suggests that mammography screening reduces breast cancer mortality, especially among older women.1 A physician’s recommendation or referral – as well as satisfaction with physicians – are major factors facilitating breast cancer screening. Currently, women ages 45-54 are recommended to get mammograms every year, and women 55 and older are recommended to get mammograms every 2 years.2
Data and methods
Mapping Medicare Disparities Tool
The Centers for Medicare & Medicaid Services Office of Minority Health's Mapping Medicare Disparities (MMD) Tool contains health outcome measures for all states and counties for disease prevalence, costs, hospitalization for 55 specific chronic conditions, emergency department utilization, readmissions rates, mortality, preventable hospitalizations, and preventive services.
Key Measure Methods
Mammography Screening is a percentage
Mammography Screening is the percentage of female fee-for-service (FFS) Medicare enrollees, ages 65-74, that receive an annual mammogram.
The method for calculating Mammography Screening has changed
In the 2019 County Health Rankings, the source for this measure switched from Dartmouth Atlas of Health Care to Mapping Medicare Disparities. The current measure now includes mammography screening for women between the ages of 65 and 74; the Dartmouth Atlas of Health Care measures only women ages 67 to 69.
The County Health Rankings measure of Mammography Screening includes women ages 65-74 on Medicare; however, by using data on only this subset of women, this measure may potentially miss trends and disparities among younger age groups or women not on Medicare.
This measure captures women who have received a mammogram in the past year; however, the current recommendation for this age group is to get a mammogram every 2 years. For this reason, our measure may underestimate the percentage of women meeting the current mammography screening recommendation.
The numerator is the number of women ages 65-74 enrolled in Medicare Part B for at least one month of the selected year who have had a mammogram in the last year (Current Procedural Terminology/Healthcare Common Procedure Coding System codes: 77052, 77057, 77063, G0202).
The denominator is female Medicare beneficiaries ages 65-74 enrolled in Medicare Part B for at least one month of the selected year. Individuals enrolled in Medicare Advantage at any point during the year are excluded.
Can This Measure Be Used to Track Progress
This measure can be used to track progress with some caveats. It is important to consider the change in data source, made in 2019, when comparing Mammography Screening data across years. Additionally, the estimate provided by the County Health Rankings includes mammography screening received by those enrolled in the Medicare FFS program only.
Finding More Data
Disaggregation means breaking data down into smaller, meaningful subgroups. Disaggregated data are often broken down by characteristics of people or where they live. Disaggregated data can reveal inequalities that are otherwise hidden. These data can be disaggregated by:
Mammography screening data by age groups, gender, and race can be obtained from the Mapping Medicare Disparities tool.
1 Elmore JG, Armstrong K, Lehman CD, Fletcher SW. Screening for breast cancer. Journal of the American Medical Association. 2005; 293(10):1245-1256.
2 Guidelines for the Early Detection of Cancer (2018). American Cancer Society.