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Women Facing 'Crisis' in Mammographies

Report Says Quality Mammography Declining in U.S.
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WebMD Health News

June 10, 2004 -- The U.S. is rapidly losing its capacity to screen women for breast cancer using mammography, a trend that is causing many women to go without screening, concludes a report issued by the Institute of Medicine (IOM) and the National Research Council.

The study says a deepening shortage of both mammography clinics and qualified doctors and technicians to operate them is damaging women's access to critical screening procedures.

Women across the U.S. wait months to get screening mammograms because facilities are overstretched, the report states.

That's on top of inefficiencies in screening techniques and shortcomings in evaluating new technologies that may also be hurting the system.

Approximately 200,000 new breast cancer cases are diagnosed in the U.S. each year, and about 40,000 women die from the disease. Most screening guidelines recommend that women first start screening for breast cancer at age 40 as a way to catch cancers early, when they are easiest to treat. But according to the report, there are not enough breast imaging specialists to keep up with the demand of the more than 1 million women who turn 40 annually.

Still, about 40% of women 40 to 64 and 36% of women over 65 did not receive mammograms in 2002, according to the IOM. Minority women and those who live in underserved areas have even lower screening rates.

According to the report, "To date no way to prevent breast cancer has been discovered and experience has shown that treatments are most effective when a cancer is detected early. ... Improving early detection and diagnosis is the most effective way to continue to reduce the toll from breast cancer."

Unfortunately, screening mammography misses about 17% of all breast cancers in women and may mistakenly label an abnormal area as a tumor where none exists in about one in 10 procedures. The relatively high inaccuracy rate may scare some women away from regular screenings, the report states.

"Mammography is imperfect. [But] we're still a long way from applying it in an optimal situation that saves lives now," says Martin Abeloff, MD, director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University and a member of the IOM panel.

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