Brief Description of Measure: CMS125: Breast Cancer Screening Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer in the 27 months prior to the end of the Measurement Period Description of Issue: The new draft U.S. Preventive Services Task Force (USPSTF) guideline recommends biennial screening of mammograms starting at age 40: https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/breast-cancer-screening-adults . The measure will incorporate the new draft USPSTF guideline which recommends biennial screening of mammograms starting at age 40 rather than at age 50. Note that the age requirement is updated to 40-74 years of age in the Description, and 42-74 years at end of the measurement period in the Initial Population Description to account for 27 months look back period. This measure will now stratify by the ages 42-51 and 52-74 by the end of the measurement period. The rates stratified by age would permit continued trending for adults 50-74 years and minimize disruption to programs that use this measure.

Proposed Solution: //Header: Description Before: Percentage of women 50-74 years[...] After: Percentage of women 40-74 years[...] //Header: Add Stratification Report a total rate, and each of the following age strata: Stratum 1: Patients age 42-51 by the end of the measurement period Stratum 2: Patients age 52-74 by the end of the measurement period //Header: Initial Population Before: Women 52-74 years of age by the end of the measurement period[...] After: Women 42-74 years of age by the end of the measurement period[...] //Logic: Initial Population and Stratification Before: define "Initial Population":   [...]     and AgeInYearsAt(date from       end of "Measurement Period"     ) in Interval[52, 74] [...] After: define "Initial Population":   [...]     and AgeInYearsAt(date from       end of "Measurement Period"     ) in Interval[42, 74] [...] Stratification 1 AgeInYearsAt(date from   end of "Measurement Period" )in Interval[42, 51]   Stratification 2 AgeInYearsAt(date from   end of "Measurement Period" )in Interval[52, 74] //Clinical Recommendation Statement and Reference Before: The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women aged 50-74 years (B recommendation) (USPSTF, 2016). The decision to start screening mammography in women prior to age 50 years should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years (C recommendation) (USPSTF, 2016). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older (I statement) (USPSTF, 2016). The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer (I statement) (USPSTF, 2016). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, magnetic resonance imaging, DBT, or other methods in women identified to have dense breasts on an otherwise negative screening mammogram (I statement) (USPSTF, 2016). [...] After: Draft Recommendation: The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women aged 40-74 years (B recommendation) (USPSTF, 2023). The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women aged 50-74 years (B recommendation) (USPSTF, 2016). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older (I statement) (USPSTF, 2023). The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer (I statement) (USPSTF, 2023). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography and magnetic resonance imaging in women identified to have dense breasts on an otherwise negative screening mammogram (I statement) (USPSTF, 2023). [...] U.S. Preventive Services Task Force. (2023). Draft Recommendation: Breast Cancer Screening. Accessed July 12, 2023.https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/breast-cancer-screening-adults Rationale for Change: Update to align with recently updated USPSTF breast cancer screening recommendations and supporting evidence.