Screening Mammography Increasing Among Older US Women, But Misconceptions Persist

WASHINGTON—Older American women are more aware of mammography and are using the procedure for breast cancer screening in increasing numbers, but ignorance and misconceptions about mammography persist, according to a new survey.

The telephone survey of a nationally representative sample of 814 women age 65 and older was conducted by the National Cancer Institute and the Health Care Financing Administration (HCFA) in the spring of 1999. Among its findings:

More than one third of the women were less concerned about breast cancer now that they were over age 65 than when they were younger, even though the risk of the disease increases with age.

Of those surveyed, 88% had had at least one mammogram in their lifetime, an increase of 25% from a similar survey in 1992 by AARP (American Association of Retired Persons). Among the women surveyed, 70% had received their most recent mammogram within the previous 2 years, up from 35% in the AARP poll.

Only 57% of the women knew about the recommendation that women have a screening mammogram every year or two starting at age 40. Minority women were twice as likely as white women—20% vs 11%—to say they did not know the age at which to begin screening mammograms.

 Half of the women had received their mammograms as part of routine preventive care, and 34% said a physician or other health care professional had recommended the screening test to them.

 Women who had never had a mammogram were the most likely to feel that they did not need one and/or to say that a doctor had not recommended it.

Of those surveyed, 77% knew that Medicare covers the cost of screening mammograms, but only 58% had used their Medicare coverage to obtain one. Again, minorities were less likely than whites to be aware of the Medicare mammography benefit, by a margin of 29% to 17%.

“These findings indicate once again that misconceptions about breast cancer risk and the potential benefit from regular breast cancer screening are prevalent among older women,” said Leslie Ford, MD, associate director for clinical research in the NCI’s Division of Cancer Prevention.

The survey was conducted to help NCI and HCFA evaluate current mammography education programs and identify areas needing additional attention.

Last year, the NCI and HCFA formed a partnership to raise awareness of the need for regular mammography screening among women aged 65 and older and of the expanded mammography screening benefit for Medicare beneficiaries. Previous educational efforts have primarily targeted women younger than 65. The partnership is also attempting to increase the number of providers who refer female Medicare beneficiaries for screening mammograms. The NCI and HCFA will work with professional medical organizations to increase awareness among providers and will develop materials that facilitate communication between providers and patients about mammography and breast cancer.