Use of mammograms declining
Cancer specialists worried by trend
WASHINGTON -- US women are getting mammograms to screen for breast cancer at declining rates, according to a study describing a trend that some health officials fear may reverse progress against the deadly disease.
The percentage of women 40 and older saying they had a mammogram within the past two years slipped from 70 percent in 2000 to 66 percent in 2005, according to the study appearing today in the journal Cancer.
The trend follows big increases in use of the tests since the 1980s. The mammography rate for women past the age of 40 was only 39 percent in 1987.
Researchers led by Dr. Nancy Breen of the National Cancer Institute said the findings followed previous indications from various parts of the country that the popularity of mammograms was ebbing.
"It's quite an unusual and disconcerting finding," Breen said. "It comes as a surprise because there's no reason you'd think there'd be a drop in mammography."
But other specialists cite a number of possible reasons, including insurance issues and recent doubts cast on the benefits of mammograms.
Many women dislike these breast X-rays because of the discomfort involved.
Most studies indicate that widespread use of mammograms have made early detection of breast cancer more common and reduced death rates from the disease.
Mammograms are used to screen healthy women for signs of breast cancer and are considered a crucial tool to detect the disease at its earliest stages when it is most treatable.
The study found declines among groups that traditionally have used mammography at high rates, including higher-income and better-educated women, those 50 to 64 years old, and non-Hispanic whites.
The findings were based on a scientific survey of about 10,000 US women 40 and older by the Centers for Disease Control and Prevention, Breen said. Mammography rates stagnated between 2000 to 2003 and then dropped in 2005, she said.
Robert Smith, the American Cancer Society's director of cancer screening, said the trend could lead to more breast cancer deaths.
"A decline in mammography utilization is going to result in a higher rate of cancers diagnosed at an advanced stage," he said. "And that will mean more aggressive treatment, and in some instances it may mean that women who would have survived if their cancer had been found earlier will not survive."
The society recommends annual mammograms for all women starting at age 40. The National Cancer Institute recommends them for these women every one to two years. Specialists also recommend mammograms for younger women with symptoms of breast cancer or who are at high risk for it.
The researchers said the drop in mammography rates may be caused by several factors, including an increase in the number of women without health insurance and less emphasis on mammography in health-promotion campaigns.