Correction to This Article
A May 14 Page One article about mammograms incorrectly said that between 2000 and 2005 there was a drop of 4 percent in the proportion of U.S. women regularly undergoing the proceduremammograms. It was a drop of four percentage points, and it was among women age 40 and over.

Fewer U.S. Women Get Breast Cancer Test

By Rob Stein
Washington Post Staff Writer
Monday, May 14, 2007

After rising steadily for decades, the proportion of U.S. women getting mammograms to screen for breast cancer has dropped for the first time, federal researchers are reporting today.

The overall rate at which women are undergoing regular mammograms fell 4 percent between 2000 and 2005, marking the first significant decline since use of the breast X-rays started expanding rapidly in 1987, the study by the National Cancer Institute and the Centers for Disease Control and Prevention found.

The reasons remain unclear, but researchers speculated that it could be due to factors such as increasingly long waiting times to get appointments, waning fears about breast cancer, the drop in hormone use after menopause, and the ongoing debate over the benefits and risks of the exams.

Regardless of the cause, the trend is worrying breast cancer experts. They credit mammograms with playing a crucial role in reducing the death toll from breast cancer, which is the second leading cause of cancer and cancer death among U.S. women.

"This is very troubling," said Nancy Breen, who led the analysis published online today by the American Cancer Society's journal Cancer. "If women are not getting mammograms, then their cancer may not be diagnosed until later stages, which could translate into higher mortality from breast cancer."

Breast cancer strikes more than 200,000 women each year and kills more than 40,000. But the odds of surviving have been rising, in part because more women are being diagnosed by mammograms at the earliest, most treatable stages. Breast cancer experts have been growing increasingly concerned, however, by reports that mammography rates have plateaued and have perhaps started to fall. The new research is the first to document the trend nationally.

"We've been anxious to look at a national sample," Breen said. "This is the first time we had a data set to examine that represents the entire United States."

Breen and her colleagues analyzed data collected by the National Health Interview Survey, an ongoing survey of about 40,000 adults conducted by the National Center for Health Statistics to track health trends.

Data from about 10,000 women surveyed showed that the mammogram rate plateaued in 2000, began to fall in 2003 and continued to drop through 2005, the survey's most recent year. Overall, the proportion of women who said they had gotten a mammogram in the past two years declined from 70 percent in 2000 to 66 percent in 2005, according to the paper, which will be published in the journal's June 15 issue.

Most alarming, the drop was greatest -- 6.8 percent -- among women ages 50 to 64, the age group most likely to benefit.

This is also the group most likely to take hormones after the onset of menopause. That practice fell dramatically in 2002 after a federal study found that hormone therapy raised the risk of breast cancer, heart attack and stroke.

Breen and her colleagues were also surprised that the drop was especially steep -- 6.3 percent -- among more affluent women.

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