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Mammography Rates Decline, But Not By Much

December 27, 2012
Written by: , Filed in: Breast Imaging
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Not too surprisingly, a new study finds declines over the past decade in screening rates for several types of cancer in the United States. Mammography rates stayed almost level, declining only slightly from 1999 through 2010.

Also not surprisingly, cancer survivors had higher screening rates than those with no cancer history.

The University of Miami Miller School of Medicine conducted the study. It was published online today in the open-access Frontiers in Cancer Epidemiology and Prevention.

“There is a great need for increased cancer prevention efforts in the U.S., especially for screening, as it is considered one of the most important preventive behaviors and helps decrease the burden of this disease on society in terms of quality of life, the number of lives lost, and insurance costs,” said lead author Tainya Clarke, research associate in the epidemiology and public health department. She continued:

But despite this, our research has shown that adherence rates for cancer screenings have generally declined, with severe implications for the health outlook of our society.

Clarke was quoted in a Miller School of Medicine news release.

She may be overstating the direness of the study’s results. Colorectal screening rates increased steadily from 2000 through 2010. Mammography slipped only a bit, a surprisingly strong performance given the confusion that followed the U.S. Preventive Services Task Force (USPSTF) decision in 2009 to no longer recommend routine mammograms for women in their 40s.

Pap tests for cervical cancer declined, but the study speculates that increased human papillomavirus vaccination rates may account for that. Prostate specific antigen testing for prostate cancer also declined, but, as the study notes, that’s not necessarily a bad thing given the skepticism that has arisen in recent years about the effectiveness of PSA tests.

The study suggests two general reasons for declining screening rates: disagreements among the USPSTF, the American Cancer Society, and other recommending bodies over cancer screening guidelines (which would apply especially to mammography), and a decline in the percentage of workers who have health insurance.

The study does make some useful points about the non-homogeneous nature of screening populations. Persuading a woman working a blue-collar job with no health insurance and no cancer history to schedule a mammogram requires a far different approach than one would use for a white-collar cancer survivor with insurance.

Related seminar: New Horizons in Breast Imaging

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