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Most Older Women Don't Get Mammograms

Study Shows Rate of Regular Screening Is Lower Than Previously Believed
WebMD Health News
Reviewed by Louise Chang, MD

June 20, 2006 -- Only about half of older white women and even fewer older black, Asian, and Hispanic women in the U.S. get regular mammograms -- a rate lower than had been thought, new research suggests.

Estimates based on self-reporting from women and widely relied upon by the medical community had placed the rate for having a mammogram every two years as high as 80% for women between the ages of 65 and 69.

But, regardless of their ethnic group, women 65 and older tend to overreport the number of mammograms they get, according to the study.

The new findings suggest the real figure for regular screenings is closer to 60% in this age group (65 to 69), and decreases with age over 69. For all women 65 and older, the rate is about 48%, according to the study, which relied upon MedicareMedicare data to estimate screening rates.

The disparity between self-reported screening rates and actual rates should serve as a wake-up call to doctors and policy makers, a study researcher tells WebMD.

"There may be a tendency to think that we are doing pretty well with screening, based on the self-reported figures," says Christopher R. Kagay, MD, of Massachusetts General Hospital. "These data remind us that we can probably do better."

Risk Increases With Age

A woman's breast cancerbreast cancer risk increases with age; three out of four breast cancers occur in women in their fifties and beyond.

But older women traditionally have not been screened as aggressively for breast cancercancer as younger women, even though the benefits are clear for those who are healthy enough to undergo treatment, says American Cancer Society spokeswoman Debbie Saslow.

"Women should continue to get regular mammograms for as long as they are in good health," she tells WebMD.

Checking the Numbers

In an effort to better understand mammogram usage among older women, Kagay and colleagues compared national MedicareMedicare data for 146,669 women to the self-reported data of mammogram usage from two large health surveillance databases. The data were collected between 1991 and 2001.

Between 70% and 80% of women aged 65 to 69 reported having been screened at least once every two years. But the Medicare findings suggest the figure is much lower.

Only about half of white women 65 and older actually had at least one mammogram every two years, compared to 40% of black women, and an even lower percentage of Asian, Hispanic and Native American women.

The figures were somewhat higher for the youngest women in the study, with 64.5% of white women between the ages of 65 and 69 getting screened, compared to 53.5% of black women.

"The gap between what older women say they are doing (with regard to screening) and what we found they are doing is not huge, but it is significant," Kagay says.

He adds that policy makers should be especially concerned by the lower than expected screening rates among nonwhite women.

Why Aren't More Women Screened?

The biggest deterrent to screening among older women is probably the failure of their health care provider to recommend it, Saslow says.

"If women of any age are told to get screened, they do," she says. "But many older women only see specialists for specific health problems, and prevention is not something they tend to focus on."

"Mammography is especially sensitive [at detecting cancercancer] in older women and older women have the highest breast cancerbreast cancer risk," Saslow adds. "It is definitely something that women should discuss with their doctors."

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