24% of O.C. Women Over 60 Don’t Get Mammograms : Health: UC Irvine survey reveals statistics. Procedure is called vital for early detection of breast cancer.

Almost a quarter of Orange County women over the age of 60 have never had a mammogram to check for breast cancer, although that age group has the highest incidence of the potentially fatal disease, according to findings released Friday by a UC Irvine researcher.

A random telephone survey of 1,000 Orange County women also found that 16.5% of women in their 50s--an age group also highly susceptible to breast cancer--had not had a mammogram, an X-ray procedure considered vital to early detection of the disease. “That is really alarming,” said Hoda Anton-Culver, director of the epidemiology program at UCI College of Medicine who tracks the incidence of cancer in Orange, San Diego and Imperial counties.

Anton-Culver said while the survey found that 26% of women in their 40s also had never had a mammogram, that result was not nearly as disturbing. “Only 30% of breast cancer is discovered in women under the age of 50. . . . It is an old-age disease,” she said, with the risk increasing with each decade.

The American Cancer Society and National Cancer Institute recommend that women have a mammogram at age 40 and then every other year until the age of 50, when they should have one a year. Women whose close relatives have had breast cancer are advised to start having mammograms earlier.

Cancer experts said many older women fail to have mammograms because they are unaware of their susceptibility to the disease, fear the procedure may be painful or uncomfortable, or cannot afford it.

The mammography findings were part of a three-year, far-ranging health survey conducted by Anton-Culver and funded by the Irvine Health Foundation. In 1991 and 1992, Anton-Culver and her researchers surveyed 6,000 randomly selected households in Orange County; the responses of 1,000 women provided the basis of the mammography results.

Anton-Culver said the survey found that women in higher income households--which she defined as having annual incomes of $30,000 or more--were twice as likely to have had a mammogram as those in less affluent households.

Similarly, women covered by medical insurance were twice as likely to have had a mammogram than those without insurance.

Education was also found to be a factor, with college-educated women being more likely to have had a mammogram. However, for women 60 and older, education did not make any significant difference.

An especially intriguing finding, Anton-Culver said, was that smokers of any age are twice as likely to have never had a mammogram as nonsmokers. That may correlate with poor attitudes about preventive health measures, she said.

Cancer experts strongly recommend mammograms for the early detection of breast cancer, along with breast self-examinations and regular physician checkups. If detected very early, breast cancer can be cured in 92% of the cases, according to the American Cancer Society.

“It picks up a lot of lumps before we can even feel them and that makes the prognosis much better,” said Dr. Richard Kammerman, a family physician and past president of the Orange County Medical Assn.

The reasons cited most often for not having a mammogram were procrastination, not knowing the importance, or simply letting the subject slip their minds, said Anton-Culver.

Also, a considerable number of women, especially in the older age groups, said a doctor never referred them for a mammogram.

Of those surveyed, 15% of women in their 50s and 14% in their 60s who had not had a mammogram said their doctors never told them to get one. By contrast, only 8% of the women in their 40s who never had a mammogram blamed lack of a physician recommendation.

“I think the family physician needs to be more aware of what he or she can offer to patients in all ages in prevention,” Anton-Culver said.

A recent national survey funded by the American Cancer Society also reported that women over 60 are less likely to have a mammogram than younger women.

Stacey Charney, spokeswoman for the American Cancer Society, said many older women mistakenly believe they cannot get breast cancer and, because they are no longer of child-bearing years, they may no longer see obstetrician-gynecologists, who are most likely to refer patients for mammograms.

This month, Charney said, the cancer society is “unveiling a national public service advertising campaign that is directed to women over 60 and their physicians to encourage women of this age group to get screened.”

In an attempt to overcome financial obstacles to obtaining mammograms, which generally cost $150 in Orange County, the local chapter of the American Cancer Society has arranged for 24 radiology centers and hospitals to provide screening mammograms for women 40 and older. The cost ranges from $55 to $95.

Since 1991, Medicare pays up to $55 for a mammogram every other year for women 65 and older.

In addition, the Susan G. Komen Breast Cancer Foundation has a free breast screening program, including mammograms, available to the indigent and women 55 and older.

Dr. Kammerman said he was not surprised by the number of older women who have not had mammograms because he said many do not receive routine medical care. “The only time they go to see the doctor is when they are sick.”

He added that he expects that to change with the emphasis on preventive medicine advocated in President Clinton’s health reform proposal. Services recommended for coverage in a draft of that plan include a mammogram every two years for women 50 and older.

Mammogram Testing

Nearly a quarter of Orange County women 60 and older have never had a mammogram. How many mammograms women 60 and older say they have had: None: 24% 1 or 2: 36% 3-7: 29% 8 or more: 8% Don’t know: 3%

Age Group Analysis

The percentage of women who have never had a mammogram: 35-39: 57% 40-49: 26% 50-59: 17% 60+: 24% Source: UCI College of Medicine