Nurseweek/Healthweek|HMOs do a good job of detecting breast cancer

HMOs do a good job of detecting breast cancer

Posted 3-8-99

Medicare HMOs are more likely than fee-for-service plans to detect early-stage breast cancer in older women, according to a recent study in the Journal of the American Medical Association.

The study, conducted by researchers from the Health Care Financing Administration and the National Cancer Institute, examined 28,600 women 65 and older who were diagnosed with breast cancer between 1988 and 1993.

While the study authors do not identify the individual plans, Arnold L. Potosky, PhD, of the NCI says they were heavily weighted toward traditional, group-staffed HMOs.

Among the findings:

Only 7.6 percent of HMO enrollees studied were diagnosed with late-stage breast cancer—after the disease had reached the inoperable point—compared to 10.8 percent of the fee-for-service members.

Of those diagnosed with early-stage cancer, 38.4 percent of the HMO members and 36.8 of the fee-for-service members underwent breast-conserving surgery. And 69 percent of women in HMOs received radiation therapy following surgery, compared with 63.7 percent of women in fee-for-service plans.

Radiation rates following lumpectomy among HMO members varied widely, however—from a low of 49.2 percent in one region to a high of 82.5 percent in another. By contrast, rates for fee-for-service members ranged only from 61.1 percent to 69 percent.

"While it’s obvious from these results that some HMOs are doing a good job in getting their patients in for breast cancer screenings, it’s also apparent that too few women are getting the whole story about the benefits of breast-conserving therapy," said oncology nurse Judy Hirshfield-Bartek, MS, RN, with Boston’s Beth Israel Deaconess Medical Center.