Fewer Mammograms Means More Breast Cancer Deaths

It is a small statistic in a straightforward report. But its impact and implications are potentially huge.

From 2000 to 2005, the percentage of women age 40 and over who received a mammogram within the previous two years fell from 76.4 percent to 74.6 percent -- a 1.8 percent drop.

A 1.8 percent drop doesn't seem like much, so why all the fuss?

Because in real terms, this means that thousands of women may have undetected breast cancer and could potentially miss the opportunity to save their own lives.

This wasn't really unexpected by those of us who try to keep up with current mammography practices.

My colleagues at the American Cancer Society noted a year ago that there had been a decline in mammography-screening compliance. We were also aware that there appeared to be a decline in mammography in women on Medicare, a group that is at particularly high risk of developing breast cancer.

During the course of the past year, we have had discussions with several different groups, including insurers and quality-assurance organizations, who were concerned about their own observations that mammography-screening rates were dropping.

Then, at the San Antonio breast cancer conference in December, there was a stunning report that from 2002 to 2003 the number of new breast cancer cases diagnosed in the United States had actually decreased 7 percent.

Decline Threatens Breast Cancer Gains

We have been making considerable progress in reducing deaths from breast cancer, despite what has been up until recently a continuing increase in the number of women diagnosed with this disease.

More recently, the American Cancer Society reported that the number of new cases diagnosed in year-to-year comparisons actually appears to be leveling off.

But what will happen in the future with respect to deaths from breast cancer if the trend detected by the Centers for Disease Control and Prevention continues, is a source of great concern.

We know that annual mammograms for women at risk for breast cancer significantly decrease deaths from this disease.

Dr. Len Lichtenfeld is deputy chief medical officer for the American Cancer Society. You can view the full blog by clicking here.

None of the advances we have made in the treatment of breast cancer even begin to have value in the treatment of a woman's breast cancer unless she starts by taking care of herself and getting a mammogram every year.

As a result of the widespread availability and uptake of mammography in the United States, we have been able to increase survival rates from breast cancer. Today, for a woman whose breast cancer is found early and not spread to regional lymph nodes, the five-year survival rate is 98 percent.

Let's take a quick look at some numbers. These are just estimates for discussion purposes, but they at least will give you some perspective on the problem.

My colleagues tell me there are approximately 80 million women in the United States who should be getting a mammogram every year as recommended by the American Cancer Society.

But of those 80 million women, not all get an annual mammogram. In fact, we estimate that about 60 percent of women currently follow that recommendation.

So, if there is a decrease in mammography compliance (as measured by the CDC's standards), that would mean about 1.44 million fewer eligible women had a mammogram in 2005 compared with 2000.

Now, let's take the next important step in this analysis.

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