Routine Mammography Screening Increases Except Among Minorities and the Elderly

The number of women receiving mammograms is higher thanever, according to the results of a study conducted by the Board of Sponsors forNational Breast Cancer Awareness Month (NBCAM). The study found that more womenare getting annual mammograms and that cancer mortality rates are declining.

Despite this encouraging news, the study also found that minority and elderlywomen are far less likely to have regular screenings (every 1 or 2 years). Thistrend is reflected in the breast cancer mortality rates among black women, asthey are more likely to be diagnosed with breast cancer at a later, lesstreatable stage.

"We’ve come a long way from the time that breast cancer screening wasnot a test that women routinely had done, but we know that more needs to be doneto reach minority women," said National Breast Cancer Awareness MonthNational Coordinator Susan Nathanson. "While the efforts of NBCAM and ourmembers have contributed to the increase in mammography rates and subsequentdecrease in death rates, we all need to focus on helping minority andlower-income women understand the benefits of mammography screening and theresources 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 bylow income, no insurance coverage, or lack of information. Overall, theproportion 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 havemade mammography available throughout this country to more and more women,"said Ellen Mendelson, MD, director of breast imaging at Northwestern MemorialHospital and professor of radiology at Northwestern University Medical School."However, we’re concerned that minority groups haven’t taken advantageof the opportunities that mammography can provide."

Moreover, the failure of physicians to discuss mammography with theirpatients may also be discouraging minority and elderly women from havingmammograms. Recommendation for mammography was found to be more frequent amongwomen who had a regular physician and health insurance. The study found thatsocioeconomic status, age, and other characteristics, excluding race andethnicity, 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 performmammograms, low reimbursement rates, and decline in the number of imagingcenters around the United States contribute to current and future access issues.Whether the closing of imaging centers and increased regulation to ensurequality services has significantly limited patient access to mammography remainsundetermined. The demand for routine or annual mammography will increase as thepopulation ages, and these issues must be monitored carefully to ensure thataccess to mammography is not put at risk.