Older women get mammograms less often than thought
Older U.S. women are less likely to undergo mammography Breast cancer screening than experts have believed, according to a study published Tuesday.
The findings, based on Medicare claims data, show that in 2000-2001, fewer than half of women age 65 or older had a Mammogram within a two-year period.
That figure is much lower than health officials have estimated based on federal surveys. In those surveys, as many as 80 percent of women in their late 60s said they’d undergone screening mammography in the past two years.
"The rate is not as high as we thought it was,” said Dr. Christopher R. Kagay, a radiology resident at Massachusetts General Hospital in Boston and the study’s lead author.
What’s more, he and his colleagues found, while surveys have shown no great racial disparity in older women’s mammography rates, the Medicare data suggest otherwise. Whereas 50 percent of white women had recently undergone a Mammogram in 2000-2001, only 40 percent of black women had done so.
The reasons for the racial gap cannot be discerned from this study, Kagay told Reuters Health, but it’s possible that socioeconomic factors play some role even though all women had Medicare coverage.
He and his colleagues report the findings in the American Journal of Preventive Medicine.
Experts recommend that women age 40 and older have a Mammogram every one to two years. Although the benefits of mammography beyond age 69 are not clear, women are still advised to keep up screening as long as their health permits.
There are exceptions, however; older women with serious health conditions, such as heart disease, may not be able to handle the rigors of cancer treatment and are not advised to undergo screening.
“Some older women should not be getting them,” Kagay pointed out. “The rate shouldn’t be 100 percent.”
What the rate should be is not clear, according to the researcher. The decision to keep having Mammograms, he said, is a personal one that older women should discuss with their doctors.
The study findings are based on Medicare claims data for nearly 147,000 U.S. women age 65 and older for the years 1991 through 2001.
Over that period, the percentage of women who’d had a Mammogram in the past two years increased from 36 percent to 48 percent. Among women ages 65 to 69, the rate was 61 percent in 2000-2001.
That’s still well below what recent national surveys have suggested, however. It’s likely, Kagay said, that many respondents in those studies simply remembered incorrectly—a well-known limitation to health surveys.
“It’s hard to remember what you’ve done in the past two years,” Kagay noted.
SOURCE: American Journal of Preventive Medicine, August 2006.
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