Breast Cancer Screening

Early Detection

On this page:

• Benefits of Mammography Screening
• Measure
• Period
• Trends
• Most Recent Estimates
• Healthy People 2020 Targets
• Groups at High Risk for Not Being Screened
• Key Issues
• Additional Information on Breast Cancer Screening

Benefits of Mammography Screening

Mammography screening allows for the early detection of breast cancer, which helps reduce mortality from breast cancer, especially in women aged 50 to 69 years. Biennial use of screening mammograms, followed by timely treatment when breast cancer is diagnosed, can help reduce the chances of dying from breast cancer.

For women between the ages of 50 and 69, there is strong evidence that screening lowers this risk by 30 percent. For women in their 40s, the risk can be reduced by about 17 percent. For women aged 70 and older, mammography may be helpful, although firm evidence is lacking.

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Measure

Percentage of women aged 40 and older, by racial/ethnic, geographic, and low-income groups, who reported having had a mammogram within the past two years.

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Period – 1987–2010

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Trends – Rising for non-Hispanic black and white women until 2000, then stable through 2010. Rates for Hispanic women remained stable during the period between 1987 and 2010.

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Most Recent Estimates

In 2010, 66 percent of women aged 40 and older had a mammogram within the past two years, a statistically significant drop from 70 percent (1998–2003). Among racial/ethnic groups, 64 percent of Hispanics (down from 65 percent in 2003), 66 percent of blacks (down from 70 percent in 2003), and 68 percent of whites (down from 70 percent in 2003) had a mammogram within the past two years, but these drops were not statistically significant. Among Asian women interviewed in California, mammography rose to 77 percent in 2009 compared to 74 percent in 2003 and again in 2005. In terms of the social determinants of health, between 1998 and 2010, mammography rates were consistently lower for women living in households with incomes at less than 200 percent of the federal poverty level. There was a consistent education gradient, with women less who had earned than a high school diploma least likely to report a Pap test, women with a high school diploma in the middle, and women with more than a high school education most likely to report being screened.

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Healthy People 2020 Targets

Healthy People 2010 targets were to increase to 70 percent the proportion of women aged 40 and older who have had a mammogram within the past two years. This target was met in 2003, but the rate dropped to 67 percent, below the target, in 2005 and remained there through 2010.

New Healthy People 2020 targets are limited to women ages 50–74. The 2008 baseline for this age group of women was 74 percent. Healthy People calls for a 10 percent improvement to 81 percent in 2020.

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Groups at High Risk for Not Being Screened

Women who are immigrants and those with lower incomes, with less education, without insurance, and lacking a usual health care provider are less likely to get screening mammograms.

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Key Issues

Cost and knowledge barriers, including lack of insurance and lack of provider recommendations for regular mammograms, need to be removed.

For women to benefit from mammography, regular screening is needed. Although millions of women have had at least one screening mammogram, many women still have not. Even among those women who have had a recent screening mammogram, many do not have them on a regular basis. In November 2009, the USPSTF modified their recommendations for mammography screening for specific age groups. For women aged 50 to 74 years, biennial mammography screening was recommended—the previous recommendation was for women aged 40 to 69. Evidence for the decision to start regular, biennial mammography screening before the age of 50 showed more harms and smaller benefits for this age group than for older women; therefore, it was recommended that this should be a decision for individual patients and their physicians to make. For women 75 years or older, the USPSTF concluded that the current evidence is insufficient to make a recommendation.

Different organizations have generated different guidelines. To see guidelines issued by the U.S. Preventive Services Task Force and others, go to http://www.ahrq.gov/clinic/USpstfix.htm. The Guide to Community Preventive Services, http://www.thecommunityguide.org/index.html , is a source of information about evidence-based approaches for enhancing cancer screening.

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Additional Information on Breast Cancer Screening

• Breast Cancer (PDQ®): Screening — Health Professionals
  http://cancer.gov/cancerinfo/pdq/screening/breast/healthprofessional
• California Health Interview Survey (CHIS) (UCLA)
  http://www.chis.ucla.edu/
• Free or Low-Cost Programs Providing Mammography and Clinical Breast Examination in Your Area
  http://www.cdc.gov/cancer/nbccedp/index.htm
• Guide to Community Preventive Services
  http://www.thecommunityguide.org/index.html
• Healthy People 2010, Volume 1, Chapter 3—Cancer
  http://www.health.gov/healthypeople/document/HTML/Volume1/03Cancer.htm
• Medicaid Coverage for Mammography and Clinical Breast Examination
  http://www.cms.hhs.gov/medicaid/
• Medicare Coverage for Mammography and Clinical Breast Examination
  http://www.medicare.gov/health/mammography.asp
• National Health Interview Survey (NHIS) (NCHS)
  http://www.cdc.gov/nchs/nhis.htm
• Phillips KA, Kerlikowske K, Baker LC, Chang SW, Brown ML. Factors associated with women's adherence to mammography screening guidelines. Health Serv Res 1998 Apr;33(1):29-53.
• State Cancer Profiles, Latest Rates, Percents, and Counts
  http://statecancerprofiles.cancer.gov/micromaps/
• US Preventive Services Task Force Recommendations (AHRQ)
  http://ahrq.gov/clinic/uspstf/uspsbrca.htm

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Page last reviewed: June 20, 2012