U.S. Officials Praise Mammogram Increase
The number of U.S. women 40 and older who have had mammograms increased nearly 30% between 1989 and 1995, clear evidence that breast cancer education and prevention programs are working, federal health officials said Thursday.
“There has been a big, big push in the last decade to get women screened, and it’s paying off,” said Dr. Nancy Lee, an official at the federal Centers for Disease Control and Prevention. “We’re seeing it in many sectors . . . and in all socioeconomic groups.”
A survey of 39 states, released in the CDC’s Morbidity and Mortality Weekly Report, showed that the proportion of women at least 40 years old who reported having had a mammogram within a two-year period jumped from 53% in 1989 to more than 69% in 1995.
“An increase of this magnitude is outstanding news,” said Health and Human Services Secretary Donna Shalala.
The rise in mammograms is consistent with growing evidence that overall breast cancer death rates have declined dramatically in recent years, most likely because of earlier detection coupled with improvements in treatment.
“There is solid evidence [that] the messages are having an impact: In the 1980s, the average breast cancer that was detected was about three centimeters in size,” said Dr. Harmon Eyre, chief medical officer for the American Cancer Society. “Today, it’s about two centimeters.”
Health officials said they remain concerned about those women who fail to get mammograms on a regular basis.
Although the CDC reported that more than 69% of women 40 and older have had at least one mammogram, only about 50% of them return to be re-screened, according to Eyre.
“For mammograms to work, they have to be repeated on a regular basis,” he said.
Breast cancer is the most commonly detected cancer in women and the second-leading cause of cancer death in women, after lung cancer. Between 1982 and 1987, the incidence of breast cancer increased about 4% annually but recently it has leveled off to about 110 cases per 100,000 population.
Routine mammography among women age 40 to 49 has been the subject of an intense international scientific debate in recent years. The impact on death rates has been unclear in this age group, while the benefit in women 50 or older has been unequivocal.
Last spring, however, the National Cancer Institute reversed its earlier--and much criticized--position against regular screening beginning at age 40 and recommended that women in this age group undergo the procedure every one to two years.
In California, the survey showed an increase of 32%, with the number of women 40 and older having mammograms rising from 57% in 1989 to 75% in 1995.
Lee said other CDC-sponsored studies have shown that such increases in mammogram use are evident across racial and socioeconomic groups, not only among white, well-educated women.
She credited a federally funded program with state health departments that provides no-cost or low-cost mammograms to low-income and uninsured women for contributing to this trend. California was among the first eight states funded under this program, which was established by Congress in 1990.
