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October 24, 2001

Mammography Screening: The Encouraging But Not So Encouraging Trends

Results from a Survey Commissioned by the Board of Sponsors for National Breast Cancer Awareness Month Show Minority Women May Have Disadvantage To Mammography Screening

 (SafetyAlerts) -  The number of women getting mammography screening is higher than ever. This good news comes from a just released study conducted for The Board of Sponsors for National Breast Cancer Awareness Month (NBCAM), a sixteen-year-old group of the nation's most influential organizations dedicated to increasing public knowledge about the importance of early detection of breast cancer. The study found that more than ever, women are getting their annual mammograms and cancer mortality rates are declining.

Despite the encouraging rise in screening practices and the overall decrease in mortality rates, the study also found a growing trend among minority and elderly women showing they are far less likely to have regular screenings (every one to two years). This news has direct impact on breast cancer mortality rates among black women, as they are more likely to have their breast cancer diagnosed at a later, less treatable stage. African- American women whose breast cancers are diagnosed early have a five-year survival rate of 89 percent.(1)

While the research indicates that the gap in screening between white and African-American women may be closing, it is Hispanic and Native American women who still lag behind in having annual mammograms. For Hispanic women 40 and older, less than 50 percent have regular mammograms.

Mammography remains the single most effective and economical method of early detection today.(2) Women who are screened annually reduce their risk of dying from breast cancer by 63 percent, about double than was previously thought. In fact, more than two million survivors are alive in the United States today, due in large part to the increase in utilization of mammography screening and women practicing good breast health.(3) Access to age- appropriate screening may be difficult to a woman unaware of good breast health practices, especially for the elderly and minority populations such as Native American, Hispanic and African-American women.

"We've come a long way from the time that breast cancer screening was not a test that women routinely had done, but we know that more needs to be done to reach minority women," said National Breast Cancer Awareness Month National Coordinator Susan Nathanson. "While the efforts of NBCAM and our members have contributed to the increase in mammography rates and subsequent decrease in death rates, we all need to focus on helping minority and lower-income women understand the benefits of mammography screening and the resources that are available to them to practice good breast health."

Barriers to Access

Minority women are at a particular disadvantage when accessing regular mammography screenings, due to low income, no insurance coverage, or lack of minority-relevant messages to inform them. Overall, the proportion of women age 40 years and older receiving mammograms increased steadily, from 58.3 percent in 1990 to 76.1 percent in 2000.(4)

"For the past ten to 15 years we have made mammography available throughout this country to more and more women," said Ellen Mendelson, MD, Director of Breast Imaging at Northwestern Memorial Hospital and Professor of Radiology at Northwestern University Medical School. "However, we're concerned that minority groups haven't taken advantage of the opportunities that mammography can provide."

Moreover, an obstacle that may discourage minority and elderly women from utilizing screening is the failure of physicians to discuss the importance of mammography with their patients. Recommendation for mammography was found to be more frequent among women who had a regular physician and health insurance. Those recommendations were less frequent among women with inadequate health care services. The recent study reported that socioeconomic status, age, and other characteristics, excluding race and ethnicity, were related to a physician recommendation for screening mammography. About 62 percent reported an adequate level of referrals for screening mammograms. (An adequate level was defined as providing the clinical preventive service more than 80 percent of the time.)

Additional barriers exist related to the providers of mammography screening. The shortage of diagnostic radiologists available to perform mammograms, low reimbursement rates, and a decline in the number of imaging centers around the United States all contribute to current and future access issues. It is not apparent whether the closing of imaging centers and increased regulation to ensure quality services has significantly limited patient access to mammography. The demand for routine or annual mammography will increase as the population ages and these issues must be watched carefully to insure that clinical access to mammography is not put at risk.

Source: PRNewswire.

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