Mammography use exceeds targets although some are still reluctant

Jul 1 2005

Mammography use by women over 40 is on the rise and already exceeds the target set by the government-led Healthy People 2010 initiative, according to a new study that also shows, for the first time, that breast cancer screening rises with age.

The study, in the July/August issue of American Journal of Health Promotion, also shows, however, that women without health insurance, personal doctors and basic preventive care are significantly less likely than other women to have had a mammogram within the previous two years.

The study, based on a national survey of 93,657 women responding to the 2002 Behavior Risk Factor Surveillance Survey, shows that 76.4 percent of women who are over 40 and living in the United States had mammograms within the two previous years. The Healthy People 2010 initiative calls for a mammography rate of 70 percent by the year 2010.

According to Kirsten Barrett, Ph.D, who led the research with Jeffrey Legg, Ph.D, a colleague at Virginia Commonwealth University, the study presents two findings that differ from previous studies:

Seventy percent of women between the ages of 40 and 49 have had mammograms in the previous two years. This was the lowest percentage recorded among the four age groups assessed. Previous studies had shown that mammography use declined with age.

African-American women were slightly more likely than white women to have had mammograms within the past two years (78 percent and 77 percent, respectively).

“We were pleased to discover that women over 40 increasingly are turning to mammograms to reduce the risks that breast cancer poses,” says Barrett. “Sadly, significant gaps still exist between women with the means and support to pursue mammograms and those who are less fortunate.”

Only 48.1 percent of women without a personal doctor or health-care provider reported having had a mammogram within the past two years.

A similar assessment of the survey data generated in 1998 found that only 67 percent of women over 40 had had mammograms in the previous two years.

Because they can provide early detection of tumors, mammograms can significantly improve a woman’s chances of surviving breast cancer, which currently accounts for about 15 percent of all cancer deaths.

Calling the study findings “interesting but not particularly surprising,” Susan J. Curry, Ph.D., director of the Institute for Health Research and Policy at the University of Illinois at Chicago, says it is “important that we continue tracking mammography utilization rates.” Curry adds that the lower percentage of women between 40 and 49 who have had mammograms “should not necessarily cause a public health alarm” since some guidelines recommend only a single baseline mammogram for women ages 40 to 49, unless they face major risk factors such as a family history of breast cancer.

The Healthy People 2010 initiative is a partnership of federal, state and local government agencies as well as private sector organizations. The organization is dedicated to preventing disease and improving the health of all people, in part, by setting targets for healthy behavior.