The number of women receiving mammograms is higher than
ever, according to the results of a study conducted by the Board of Sponsors for
National Breast Cancer Awareness Month (NBCAM). The study found that more women
are getting annual mammograms and that cancer mortality rates are declining.
Despite this encouraging news, the study also found that minority and elderly
women are far less likely to have regular screenings (every 1 or 2 years). This
trend is reflected in the breast cancer mortality rates among black women, as
they are more likely to be diagnosed with breast cancer at a later, less
"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."
Factors Affecting Screening
The study found that regular screening of minority women may be hindered by
low income, no insurance coverage, or lack of information. Overall, the
proportion of women aged 40 years and older receiving mammograms rose steadily,
from 58.3% in 1990 to 76.1% in 2000. "For the past 10 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, the failure of physicians to discuss mammography with their
patients may also be discouraging minority and elderly women from having
mammograms. Recommendation for mammography was found to be more frequent among
women who had a regular physician and health insurance. The study found that
socioeconomic status, age, and other characteristics, excluding race and
ethnicity, were related to a physician recommendation for screening mammography.
About 62% reported an adequate level of referrals for screening mammograms.
In addition, the shortage of diagnostic radiologists available to perform
mammograms, low reimbursement rates, and decline in the number of imaging
centers around the United States contribute to current and future access issues.
Whether the closing of imaging centers and increased regulation to ensure
quality services has significantly limited patient access to mammography remains
undetermined. The demand for routine or annual mammography will increase as the
population ages, and these issues must be monitored carefully to ensure that
access to mammography is not put at risk.