Breast Cancer Test Surveyor ‘Encouraged’ : Mammograms: Researcher, however, lists some older women, Asians and the less-educated as less likely to have the test.

Despite increased publicity about the importance of routine mammograms for early detection of breast cancer, 20% of Orange County women over 40 have never had one, according to a poll released Wednesday by UC Irvine researchers.

Older women, Asian women and less-educated women were least likely to have mammograms in Orange County, the poll showed.

And the primary reason they cited for never seeking the brief, non-invasive exam that can find cancer at a curable stage?

“They just never thought of it,” said Dr. Hoda Anton-Culver, the UCI epidemiologist who sampled a total of 962 women last October and this April for the Orange County Health Research Surveys.

Of women who never had had a mammogram, 33% said the idea of the test hadn’t crossed their minds. Another 26% said they “thought it was not necessary”; 14% said “their doctor never recommended it”; 9% just procrastinated and 1% were worried about radiation, Anton-Culver said. She noted that the possibility of getting excess radiation from mammography was a legitimate concern some years ago but is not now a problem.

The Orange County Health Research Surveys--a 2-year-old project funded by the Irvine Health Foundation--has been studying the incidence of medical problems here as well as local attitudes toward health care. Additional 1990 survey results, including how Orange County residents were affected by this summer’s controversial malathion spraying, are to be released Sept. 19.

Anton-Culver, who also serves as president of the American Cancer Society’s Orange County chapter, said that overall she was “very encouraged by the high percentage of women, especially those over 40, who have had at least one mammogram.” Her survey showed that 69% of respondents over age 40 have been tested at least once.

She stressed that the risk for breast cancer goes up after age 40. The American Cancer Society and the National Institute of Cancer recommend that women should have a mammogram at least once a year after the age of 50--and some doctors believe that women should be tested after the age of 35 so that cancer can be detected early and treated effectively.

Anton-Culver also said that she was especially pleased that a high percentage of both Anglo and Latino women--55.2% and 53.2% respectively--reported having a mammogram.

The epidemiologist said she was pleased that Latinas are getting mammograms for health-care prevention, but “I am discouraged that we are not reaching the same . . . proportion of Asians. And I am discouraged that women in general, especially those over 40, are not going to mammography in a routine fashion. The rate of cancer (in Orange County) looks to me higher than what it should be.”

She noted that 37.5% of the 1,200 breast cancer cases diagnosed each year in Orange County are caught “at a late stage,” when treatment is less likely to be effective.

The survey showed that only 28.9% of Asians (Japanese, Chinese, Vietnamese, Pacific Islanders) had ever received a mammogram. (Also in the poll: 41.7% of black women over 18 surveyed had received a mammogram.)

A low number of Asian women are getting mammograms despite the fact that the ACS in the last few years has regularly publicized free or low-cost mammograms ($50 instead of fees up to $180).

“It could be a language problem, an access problem, I don’t know,” Anton-Culver said, but she believes that a special effort should now be made to screen Asians for breast cancer.

Poll results also showed that while women in their 50s and 60s were likely to have had three or more mammograms (respectively 40.8 and 42.2% of those groups reported having several mammograms), older women had mammograms less frequently. For instance, only 35% of women in their 70s had had three or more mammograms and 34.5% of women in their 80s reported three or more mammograms.

Also, Anton-Culver said, the survey showed that education appears to influence the frequency of seeking mammography. She found that 46.2% of women with an education level of eighth grade or less had lower frequency levels compared to 49.2% of those with ninth- to 12th-grade education and 56.2% for those with a college education.

SURVEY RESULTS

Percent of women who have had at least one mammogram:

ANGLO: 55.2

LATINO: 53.2

BLACK/AMERICAN INDIAN: 41.7

ASIAN/PACIFIC ISLAND: 28.9

Source: Orange County Health Surveys