Few Women Get Annual Mammograms
Study: Just 6% of Women Get Screening Test Annually
June 21, 2004 - The American Cancer Society and other health groups call for annual mammograms beginning at age 40, but new research suggests that only a small fraction of women continue to get screened every year.
A new study shows that roughly one woman out of 20 who were initially screened for breast cancer with a mammogram continued to have annual screening exams over the next decade. Most of the women got the recommended annual exam only about half as often as guidelines suggest.
Researchers say that breast cancer screening with mammograms could save far more lives if more women got them when they should.
"Studies suggest that waiting more than a year between screenings decreases the lifesaving capacity of mammography," researcher James S. Michaelson, PhD, tells WebMD. Waiting longer, he says, could mean the difference between detecting a localized cancer and one that has spread. Finding breast cancer at an early stage means it will be most responsive to treatment and will lower the risk of dying from the cancer.
Few Women Get Annual Test
The Massachusetts General study is among the largest and most comprehensive assessments of mammography usage ever conducted. It included almost 72,500 women who received screening mammograms at the hospital between 1985 and 2002. Researchers analyzed screening trends within subgroups based on age, race, prior history of breast cancer, and socioeconomic status.
Overall, just 6% of women who got screened in 1992 had a mammogram each year over the next 10 years. Usage was highest among higher-income women or those with insurance, and among women who had a previous history of breast cancer. But even these women showed poor compliance with annual screening guidelines.
"It was not a huge surprise that uninsured women and those who didn't speak English came back less often than the population as a whole," Michaelson says. "But it did surprise me that so few women across all subgroups followed the recommendations to get screened every year."
According to the researchers, the low use of annual mammograms was not different from other populations that have been studied.
Patients Need Reminders
Michaelson says that most women do not consciously choose to ignore screening guidelines. It is more likely, he says, that they lose track of when they need a mammogram and are not reminded by their physicians.
He cites a Wisconsin telephone survey in which roughly 60% of women recalled receiving a reminder from their dentist about an appointment and 70% recalled similar reminders from their veterinarians. Just 9% said they recalled being notified that it was time to have a mammogram.
"Reminders are a somewhat unglamorous and neglected aspect of breast screening, but we believe that their use can have an enormous impact on breast cancer death rates," the researchers wrote.
American Cancer Society spokesman Len Lichtenfeld, MD, agrees that doctors need to do a better job of stressing the importance of annual screening.
"We now know that this one-year interval is very important, but I don't think that has filtered down to the women who could benefit from regular screenings," he says. "It's up to us to get the word out."