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Women Ignoring Message About Mammograms

Study finds just 1 in 20 follow recommendations

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HealthDay Reporter

MONDAY, June 21, 2004 (HealthDayNews) -- Most women ignore recommendations to undergo regular mammograms, and as a result miss out on the lifesaving benefits of the screening exam, a new study concludes.

The study also found that, among women diagnosed with invasive breast cancer, those who had prompt annual mammograms had a lower risk of death, about 12 percent, compared to those who received mammograms every two years (about 16 percent) or every five years (25 percent).

Only one in 20 women consistently follow the recommendation for annual mammograms for women age 40 and older, said James Michaelson, assistant professor of pathology at Harvard Medical School and Massachusetts General Hospital. He is the lead author of the study, published in the June 21 online issue of Cancer, a journal of the American Cancer Society.

"There have been other studies over the past few years that have told us screening is not used to its fullest advantage," Michaelson said. "But this is probably the most detailed, largest study."

Michaelson and his colleagues reviewed data from more than 72,000 women who received screening mammograms at the Massachusetts General Hospital's Avon Comprehensive Breast Center from 1985 to 2002. They analyzed information within subgroups of women based on race, age, prior history of breast cancer, and their socioeconomic status. Then they used a computer simulation model of breast cancer to estimate the health consequences of various screening intervals.

In all, only 6 percent of women who got a mammogram in 1992 received all annual mammograms that were available to them over the next 10 years. The mean number of mammograms received during the 10-year period was about five, or half the number recommended by the American Cancer Society.

The society and many other organizations recommend annual mammograms for women at age 40. "But as a group, they only used one of two mammograms they could have taken advantage of," Michaelson said.

Women from lower economic status got fewer mammograms than women who were more affluent. Hispanic, black, and Asian women got fewer mammograms than did women of other races.

While fear of discomfort or fear of a cancer diagnosis may play a role in women not getting regular mammograms, "my own hunch is we simply don't do a very good job of reminding them," Michaelson said.

"Dentists do a very good job of reminding their patients," he said. "I'm very interested in developing automatic systems to send computer-generated reminders to people to help them remember they have appointments."

The study findings come as no surprise to Dr. Gail Lebovic, an associate professor of surgery at the University of Southern California's Keck School of Medicine and associate director of the university's Lee Breast Center. "I think it's really an important study and points out clearly the importance of mammography," she said.

"It basically confirms what we have known for a long time and what the American Cancer Society has been trying to tell women for years -- that screening mammography works in terms of detecting cancer early and reducing deaths."

Fear of discomfort is a barrier to screening, Lebovic believes. To counteract that, she developed the Woman's Touch MammoPad, a disposable cushion placed on the mammography equipment before a woman has the test, cushioning the breast during compression. It's now used by about 1,500 centers, she estimates.

Sometimes, a woman's gynecologist or family physician simply forgets to refer her for the mammogram, Lebovic said. She suggests simple ways woman can remember each year.

"Do it on your birthday, or around your birthday. Or do it the first of the year," she said. The date itself doesn't matter, she said, but keeping it the same time each year will make it more difficult to forget.

Breast cancer is the most commonly diagnosed cancer in U.S. women, according to the American Cancer Society, with an estimated 267,000 new cases diagnosed in 2003 and about 40,000 deaths.

More information

Read about detecting breast cancer early from the American Cancer Society.

SOURCES: James Michaelson, Ph.D., assistant professor of pathology, Harvard Medical School and Massachusetts General Hospital, Boston; Gail Lebovic, M.D., associate professor of surgery, University of Southern California Keck School of Medicine and associate director, of the Lee Breast Center, USC/Norris Comprehensive Cancer and Hospital, Los Angeles; June 21, 2004 Cancer online

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