Most women do not get recommended mammograms

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Colored x-ray of the breast reveals a malignant tumor (black).
Colored x-ray of the breast reveals a malignant tumor (black).

Many women aged older than 40 do not get an annual mammogram, even if they have insurance to pay for it, findings from a recent study indicate.

In Nov. 2009, the U.S. Preventive Services Task Force (USPSTF) updated breast cancer screening guidelines, bumping up the age at which annual mammograms should be recommended from 40 years to 50 years. The recommendations stated that annual screening for women aged 40 to 49 years should be determined on a case-by-case basis and that screening every two years is sufficient.

“There was a loud outcry. We heard, ‘Don't take away my right or my ability to have a mammogram regularly,'” study researcher Milayna Subar, MD, said at the 33rd Annual CTRC-AACR San Antonio Breast Cancer Symposium in Texas.

Subar is vice president and the national practice leader for oncology at Medco Health Solutions, a pharmacy benefits management company based in Franklin Lakes, N.J. She and colleagues analyzed data from their medical claims database of more than 12 million people to determine actual breast cancer screening compliance, and presented the results at this week's meeting.

Despite nuances in recommendations from USPSTF, the American Cancer Society, and other health care organizations concerning the age at which annual mammography should begin, all guidelines recommend that healthy women age 40 and older get at least one mammogram every two years

The researchers found that only 60% of women aged 40 to 85 years included in their database adhered to this recommendation during a three-year period from January 2006 to December 2009. Average annual mammography rates were 47% among women aged 40 to 49 years, 54% among those aged 50 to 64 years and 45% for women aged 65 and older.

Although the researchers did not study factors contributing to lack of compliance, Subar speculated that guideline inconsistencies in screening recommendations might have something to do with it.

“I think, it's possible that women are asking themselves, ‘Well what should I do?” she said.

Other potential factors are fear about procedure-related discomfort, cost concerns, fewer facilities offering mammogram services and an unmet demand for breast cancer screening specialists due to lack of sufficient training programs, according to the researchers.

“Continued public education and access to mammography are of utmost importance in reaching target breast cancer screening goals,” Subar said.

You can find podcasts of this data and much more from the 33rd Annual San Antonio Breast Cancer Symposium online, here.

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