Older women and their physicians cite age as one reason why patients 65 and up don’t undergo regular mammography. In one U.S. state, nearly 60% of older women did not take advantage of the Medicare benefit for breast cancer screening in the late 1990s, according to research from the University of Michigan in Ann Arbor.
R. Van Harrison, Ph.D., and colleagues analyzed variations in mammography use over a five-year period (1993-1997). In particular, they wanted to see if screening compliance had increased 2 years after the 1991 introduction of the Medicare mammography benefit. They reported their results in the March 1, 2003 issue of Cancer.
"During the first years of Medicare coverage, the majority of older women were unaware that screening was a benefit," the authors wrote. "Self-reported 2-year mammography screening rates for women age 65 years increased from 43% in 1990 to 64% in 1998. Although this increase is appreciable, the rate still is below national recommendations" (Cancer, March 1, 2003, Vol. 97:5, pp.1147-1155).
For this study, the group used annual Michigan Medicare beneficiary files for a random sampling of 10,000 women who were age 70 or older by 1997. They determined whether each woman had received any mammogram in the preceding 5-year period, and, if so, how many. They included two-view (screening) and six-view (diagnostic) mammograms.
According to the results, 43% of the women in this analysis did not undergo any kind of breast cancer screening in the 5-year period. Of this 43%, only 9% had a condition that would prevent them from undergoing mammography (cancer, major mental or physical disability), leaving 34% who had no legitimate health reason for skipping out on an annual exam.
The segment of women that did undergo cancer screening averaged 2.8 mammograms over the 5-year period. The level of physician involvement in their healthcare was a strong predictor of whether a woman had a regular mammogram, the group reported. The rate for ever having undergone a mammogram was 71% for women who saw an ob/gyn. Other predictors were fewer inpatient admissions and younger age.
"The results of the current study suggest priorities for interventions to increase mammography among older women," the authors suggested. "Messages to both older women and physicians should be strongly worded to correct the misperception that mammography screening is less important as women age."
By Shalmali PalAuntMinnie.com staff writer
February 19, 2003
Related Reading
Older German women unaware of breast cancer risk, forego mammograms, January 16, 2003
Non-whites in U.S. at greater risk for advanced breast cancer, January 14, 2003
Mammography in women over 75 identifies smaller, earlier stage tumors, November 20, 2002
Mammographic breast cancer detection ups survival in women from age 65 to 85, July 12, 2002
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