Annals of Surgical Oncology Cite Track
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kuerer, H. M.
Right arrow Articles by Esserman, L. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kuerer, H. M.
Right arrow Articles by Esserman, L. J.
Related Collections
Right arrow Other Medical

Annals of Surgical Oncology, Vol 7, Issue 5 325-332, Copyright © 2000 by Society of Surgical Oncology

ARTICLES

Current national health insurance coverage policies for breast and ovarian cancer prophylactic surgery

H. M. Kuerer, E. S. Hwang, J. P. Anthony, R. A. Dudley, B. Crawford, W. M. Aubry and L. J. Esserman
Department of Surgery, University of California at San Francisco, USA.

BACKGROUND: The efficacy of prophylactic mastectomy and oophorectomy in reducing breast and ovarian carcinoma has recently been reported in high-risk women. Because cost has become central to medical decision-making, this study was designed to evaluate currently existing coverage policies for these procedures. METHODS: A confidential detailed cross-sectional nationwide survey of 481 medical directors from the American Association of Health Plans, Medicare, and Medicaid was conducted. RESULTS: Of the 150 respondents, 65% (n = 97) had 100,000 or more enrolled members and 35% (n = 53) had fewer than 100,000 enrolled members. Only 44% of private plans have specific policies for coverage of prophylactic mastectomy for a strong family history of breast cancer and 38% of plans for a BRCA mutation. Only 20% of total responding plans had a policy for coverage of prophylactic oophorectomy under any clinical circumstance. Governmental carriers were significantly less likely to have any policy for prophylactic surgery (range, 2%-12%) compared with nongovernmental plans (range, 24%-44%; P < .001). No significant regional differences for coverage policies were identified (P > .05). CONCLUSIONS: Significant variations currently exist for health insurance coverage of prophylactic mastectomy and oophorectomy. As genetic testing becomes widespread, more uniform policies should be established to enable appropriate high-risk candidates equal access and coverage for these procedures.


This article has been cited by other articles:


Home page
 Science Technology Human ValuesHome page
I. Lowy and J. P. Gaudilliere
Localizing the Global: Testing for Hereditary Risks of Breast Cancer
Science Technology Human Values, May 1, 2008; 33(3): 299 - 325.
[Abstract] [PDF]

Home page
 Cancer Epidemiol. Biomarkers Prev.Home page
O. I. Oloparde
Genetics in Clinical Cancer Care: A Promise Unfulfilled among Minority Populations
Cancer Epidemiol. Biomarkers Prev., November 1, 2004; 13(11): 1683 - 1686.
[Full Text] [PDF]

Home page
 Med Decis MakingHome page
N. F. Col
The Use of Gene Tests to Detect Hereditary Predisposition to Chronic Disease: Is Cost-Effectiveness Analysis Relevant?
Med Decis Making, September 1, 2003; 23(5): 441 - 448.
[Abstract] [PDF]

Home page
 JNCI J Natl Cancer InstHome page
H. T. Lynch, J. F. Lynch, and W. S. Rubinstein
Prophylactic Mastectomy: Obstacles and Benefits
J Natl Cancer Inst, November 7, 2001; 93(21): 1586 - 1587.
[Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
L. A. Newman, H. M. Kuerer, K. K. Hunt, G. Vlastos, F. C. Ames, M. I. Ross, and S. E. Singletary
Educational Review: Role of the Surgeon in Hereditary Breast Cancer
Ann. Surg. Oncol., May 1, 2001; 8(4): 368 - 378.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2000 by the Society of Surgical Oncology.