Women in New York City continue to receive mammograms at much lower levels than those outside the downstate region

Women in New York City continue to receive mammograms at much lower levels than those outside the downstate region, while Kings County (Brooklyn) still has the lowest county-specific mammography rate, according to IPRO's second annual "snapshot" of mammography usage in New York State.

In its analysis of claims for non-HMO Medicare beneficiaries ages 52-69, IPRO also found persistent statewide mammography disparities between black and white women. IPRO is an independent healthcare quality evaluation and improvement organization.

"We are very concerned that these numbers remain low, particularly for African-American women in New York City," says Clare B. Bradley MD, MPH, Chief Medical Officer, IPRO. "While the rates are typical of long-term trends of low mammography usage in the city and longstanding disparities throughout the nation, we believe the time is right for change. There is clear evidence that mammography saves lives, particularly in this age group."

New York City mammography rates ranged from 44.6% in Brooklyn (up 1.4% from last year's report) to 50.3% in Manhattan (even with last year), with a city-wide average of 47.3% (up .1%). The national average was 59.3% (down .7%) and the state average 57.4% (down .6%). African Americans across the state had an average mammography rate of 47.5% (up .9%), while the rate for whites was 60.1% (down .8%). Statistics are derived from Medicare claims and represent the most recent data available -- October 1, 2001 to September 30, 2003.

"We hope the release of these data will spur health care providers to participate in our quality improvement initiatives, and encourage Medicare beneficiaries to speak with their care givers about referrals for screening mammography," says Terry Mahotiere, MD, MPH, Medical Officer at IPRO. "Providers can address a large part of the performance gap by discussing the need for mammography with their patients."

IPRO is conducting outreach and providing technical assistance to more than 1,000 physicians in 500 practices, with the goal of increasing mammography rates. In addition, IPRO is providing free educational materials and offering free Continuing Medical Education (CME) credits for participation in quality-improvement activities.

Breast cancer is the second most common type of cancer among women in the United States. The American Cancer Society estimates that nearly 216,000 will get breast cancer this year and more than 40,000 will die from the disease. As a woman ages, the chances of getting breast cancer increases. Based on a lifespan of 80 years, one in nine women is at risk of developing breast cancer. Studies have shown that screening mammograms are still the best method for early detection and that regular screening mammography can decrease the chance of dying from breast cancer.

Medicare pays for a screening mammogram to detect cancer once a year, and also pays for diagnostic mammograms, when they are furnished by facilities that meet FDA certification requirements.

For the purposes of this data release, IPRO defines downstate as including New York City's five boroughs and Long Island.

With 20 years experience in health care quality evaluation, IPRO holds major contracts with state and federal governments to review the cost and quality of services provided to Medicaid recipients, Medicare beneficiaries, and patients enrolled in managed care organizations. Based in Lake Success, New York, IPRO also holds contracts with private-sector clients to improve the quality of privately financed services.

IPRO's consumer web site has a wealth of information on breast cancer and mammography including educational materials, resource listings and links. In addition, the site enables women to locate an FDA-certified mammography center near them, simply by entering their zip code.