Younger Women With Family History Skip Mammograms

New research says fear may be the key factor

FRIDAY, Feb. 21, 2003 (HealthDayNews) -- Younger women with a family history of breast cancer are less likely than others to get regular mammograms.

That's the surprising finding of a new study that evaluated almost 30,000 women.

While the study showed that educated white women with higher incomes and insurance coverage are the most likely to get routine breast-cancer screenings, it also showed that women in their 40s with a family history of the disease were less likely to do so.

The reason, says the study's author, could well be fear.

"Fear may have a negative impact. People are more afraid of being diagnosed [if they have a family member with breast cancer]. There is kind of a denial situation," says Dr. Saleh Rahman, an assistant professor of public health at Bowling Green State University. He will present his findings Feb. 22 at the Preventive Medicine 2003 meeting in San Diego.

For the study, Rahman evaluated the records of 27,778 women, aged 40 to 90, who were entered into the database of the Colorado Mammography Project. He and his colleagues conducted the analysis from 1994 to 1998, looking at race, educational level, income, insurance status and family history to see which factors predicted how women adhere to the screening recommendations.

Overall, 41.4 percent got a mammogram as recommended, Rahman says. That's an improvement from earlier years, he adds, noting that a 1987 government survey found only 30 percent got a mammogram as advised. In Rahman's study, women who were more highly educated, with higher incomes and insurance coverage, were most likely to get regular mammograms.

Older women were more likely to get regular mammograms than the younger women in general, he also found.

Rahman had predicted some factors would influence whether women got mammograms, such as ethnicity, education, age and income, but he hadn't thought that family history would decrease the likelihood.

"We need to develop behavioral interventions addressing these factors to neutralize those fears," he says.

The new study findings are at odds with some other research, says Debbie Saslow, director of breast and gynecologic cancers for the American Cancer Society.

"I'm glad they did the study," Saslow adds, "[but] I was a bit surprised [by some of the findings."

"We've seen a lot of national statistics that show black and white women are getting mammograms at equal rates," Saslow says. "Perhaps this study has found regional differences or localized differences. Or it could be things have changed since the analysis was done."

Overall, research on whether women with a family history of breast cancer get regular mammograms or skip them has been mixed, Saslow says: "Some go into denial, some adhere."

In the Rahman study, the younger women were less likely to get a mammogram. In years past, Saslow says, there used to be a difference in adherence between younger and older women, with women over age 65 less likely to get mammograms. "Now that difference is going away," she says.

The American Cancer Society recommends that all women age 40 and older have annual mammograms. This year, an estimated 211,300 new cases of invasive breast cancer are expected to occur among women in the United States, and 55,700 new cases of localized breast cancer are expected to be diagnosed. More than 40,000 deaths from breast cancer are expected in 2003.

More information

For questions and answers about mammograms, see the National Cancer Institute. For the NCI statement on mammography, go here.

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