Fewer Mammograms, More Cancer Later

The information about breast cancer keeps on coming.

We have witnessed a number of new research reports over the past six months that would have anyone interested in the subject of breast cancer reeling from the various -- and at times conflicting -- messages contained in these reports.

Now, we have another article published in the current issue of Cancer that shows that mammography rates have fallen precipitously from 2000 to 2005.

If you are a regular reader of this blog, you might be asking, "What's new about that?" After all, we have been discussing the various reports about the decreasing incidence of breast cancer and the decrease in screening mammography for some time.

In fact, this new study adds further strong confirming evidence that we are facing significant challenges when it comes to the early diagnosis of breast cancer.

This new report, which is authored by investigators from the National Cancer Institute (NCI) and the Centers for Disease Control and Prevention (CDC), found that mammography screening rates dropped nearly 4 percent from 2000 to 2005.

Of particular note was the drop in mammography screening in women between the ages of 50-64, who are generally the highest utilizers of mammography screening. In this group, the decline was 6.8 percent over the five-year time frame.

Decline in Detection

As I mentioned, we have been hearing a lot of information about breast cancer incidence and mammography rates over the past six months. In fact, there have been concerns about these issues for some time.

This September, in our annual report to the nation, my colleagues (and other collaborators) reported a 4.8 percent decline per year in the incidence of breast cancer from 2000 to 2003.

Then, in December 2006, researchers made a presentation at a breast cancer conference in San Antonio that a detailed analysis of a national cancer database called SEER showed there was a declining incidence of breast cancer over roughly the same time period.

The press stood up and took notice of that presentation, and there were numerous reports on the topic in the national media.

In late January 2007, the Centers for Disease Control and Prevention (CDC) reported, for the first time, a significant decline in the use of screening mammography between 2000 and 2005. The decline, reported to be 1.8 percent in women age 40 and over who reported having a screening mammogram sometime in the past two years, didn't seem like much.

At that time, I reported in my blog that those numbers were in fact substantial, and suggested through a crude analysis that thousands of breast cancers were present but not being diagnosed since fewer women were having screening mammograms.

Undetected Cancer Is Still Cancer

Basically, if you don't look for an early breast cancer, you won't find it.

The problem is that if you don't find breast cancer early through a screening mammogram, it will eventually grow into a more serious cancer that will be found later. Then, the cancer has a greater chance of being larger. It also has a greater probability of spreading to the lymph nodes under the arm, or worse yet, to other parts of the body.

Each step along this path means a lower chance of cure. It means that we are going backward in our progress in the treatment of breast cancer, instead of going forward to improve the outlook for the thousands of women who are diagnosed with this disease every year.

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