Fewer Women Getting Mammograms
Decline May Lead to More Late-Stage Cancers
May 14, 2007 -- Fewer American women are getting mammograms, with usage
rates dropping the most among those who have traditionally been most likely to
be screened for breast cancer.
After rising steadily during the 1990s, mammography screening rates leveled
off after 2000 and began to decline about 2003, according to a new report from
the National Cancer Institute.
Between 2000 and 2005, usage dropped by roughly 7% among women between the
ages of 50 to 64 and 4% among women over 65.
The decline has coincided with a dramatic drop in breast cancer cases,
leading to concern that some of the observed decline in incidence may be due to
If that is the case, an increase in breast cancers detected in their later,
less-treatable stages can be expected within the next few years, says NCI
economist Nancy Breen, PhD, one of the study researchers.
“We can’t say that this is what we will see yet, but we will be watching
very carefully," Breen tells WebMD.
1 in 3 Women Aren’t Screened
The American Cancer Society recommends annual mammogram screenings for
average-risk women aged 40 and older, while NCI guidelines call for screening
every one to two years for women aged 40 and older.
Between 1987 and 2000, mammography screening rates jumped from 39% to 70%
among eligible women 40 and over.
The new report, taken from a nationally representative survey of health
trends, shows that 66% of eligible women were screened in 2005.
Breen says the change in direction is cause for concern but not yet cause
“This is a heads up, but not a calamity at this point because the drop is
pretty small,” she says. “We need to have a better understanding of the causes
of the decline so that we can start to design interventions to address those
Access and Attitude
There is growing concern that women may have less access to mammography
screening than they have had in the past because of a decline in mammography
centers and radiologists specializing in breast cancer screening and an
increase in the number of women in the U.S. who are uninsured or
“When co-pays go up, or you lose your health insurance, or the health center
you have gone to in the past stops performing mammograms, all of these things
can have the effect of eroding the will to screen,” American Cancer Society
director of screening Robert Smith, PhD, tells WebMD.
Though declining access is a major concern, it did not appear to be the only
cause of the most recent drop in mammography usage.
Some of the sharpest declines were seen among women with the highest family
incomes, those with regular access to medical care, and those with both public
and private health insurance.
Breen says reports questioning the value of regular breast cancer screening
may have had an impact on usage, as has the news that breast cancer incidence
“There may be a mistaken belief that their personal risk is lower,” she
says. “The main message is we cannot assume that because women have been
screened in the past that they will continue to get screened.”
Smith adds that getting women to understand the importance of regular
screening is among the biggest challenges facing organizations like the ACS and
“Women need to remember that the value of mammography is achieved through
regular screening,” he says.