Important Facts for Breast Cancer Screening (Mammography)

Definition

The proportion of women 40 years or older who reported having a mammogram in the last two years.

Numerator

The number of women 40 years or older who reported having a mammogram in the last two years.

Denominator

The total number of female survey respondents aged 40 or older excluding those who responded "don't know" or "refused" to the numerator question.

Data Interpretation Issues

In 2016, age distribution was changed from 8 groupings to 5 groupings; this may affect the interpretation of data trends.

Why Is This Important?

Breast cancer is the most commonly occurring cancer in U.S. women (excluding skin cancers) and the leading cause of female cancer death in Utah. Deaths from breast cancer can be substantially reduced if the tumor is discovered at an early stage. Mammography is currently the best method for detecting cancer early. A mammogram is a noninvasive x-ray used to look for early signs of breast cancer. Clinical trials and observational studies have demonstrated that routine screening with mammography can reduce breast cancer mortality by roughly 20% for women of average risk.^1^ The American College of Radiology (ACR) and Society of Breast Imaging (SBI) recommend getting annual mammograms starting at age 40 for women of average risk, but earlier and more intensive screening for high-risk patients.^2^ Significant scientific evidence has demonstrated that this approach saves more lives than delayed or less frequent screening.^3^[[br]] [[br]] ---- 1. Myers ER, Moorman P, Gierisch JM, et al. Benefits and harms of breast cancer screening. JAMA. doi:10.1001/jama.2015.13183.[[br]] 2. D.L. Monticciolo et al. Breast cancer screening in women at higher-than-average risk: recommendations from the ACR. J Am Coll Radiol, 20 (9) (2023), pp. 902-914.[[br]] 3. American College of Radiology Committee on BI-RADS. Mammography Saves Lives. Available at: [https://www.acr.org/Practice-Management-Quality-Informatics/Practice-Toolkit/Patient-Resources/Mammography-Saves-Lives]. Accessed on January 1, 2023.

Other Objectives

CSTE Chronic Disease Indicators

How Are We Doing?

Between 1989 and 2022, the percentage of Utah women aged 40 or older who reported receiving a mammogram within the last two years increased from 51.6% to 63.8%. Although rates have increased some over time, the rate in Utah still falls far below the national average. In 2022, the mammography screening rate in Utah was significantly lower than the U.S. rate of 68.2%. Utah is ranked 44th in the nation for mammography screening. In 2022, the percentage of women who received a mammogram in TriCounty Local Health District (52.7%) was statistically significantly lower than the state average (63.8%). Conversely, the screening rate in Summit County Local Health District (78.4%) was significantly higher than the overall rate in Utah. See additional data views for more specific geographic differences between the Utah Small Areas. For the same year, there were no significant differences in mammography screening rates between Hispanic and non-Hispanic ethnic groups, nor were there any significant differences in rates among different racial groups for combined data years 2018, 2019, 2020, and 2022. Mammography rates generally tend to increase with age, education level, and amount of household income increases. In 2020 and 2022 combined, women age 40-49 had significantly lower rates of mammography screening (52.4%) than older women (69.3%; most likely due to differing guidelines concerning the age at which breast cancer screening should begin). Looking at the level of education completed for the same time period, college graduates were significantly more likely to have received a mammogram (67.8%) than the general population (63.3%), whereas the screening rate among women who had not completed high school was significantly lower than the state average at just 53.4%. In the same timeframe, women in households with an annual income of less than $25,000 were significantly less likely to have had a mammogram in the past two years (50.9%) compared to other women, whereas women in households with an annual income of more than $75,000 were more likely to have had a mammogram in the past two years (68.4%).

How Do We Compare With the U.S.?

Nationally, the percentage of women aged 40 or older who reported receiving a mammogram in the past two years increased from 55.2% in 1989 to 68.2% in 2022. Since 1994, the mammography screening rate in Utah has consistently fallen below the U.S. rate. In 2022, only 63.8% of Utah women aged 40 and older had received a mammogram in the last two years compared with 68.2% of U.S. women. Utah is ranked 44th in the nation for mammography screening.

What Is Being Done?

The Utah Breast & Cervical Cancer Program (Utah B&C) partners with local health departments, community clinics, hospitals, and healthcare professionals to help those with low incomes who do not have adequate insurance gain access to timely breast and cervical cancer screening, diagnostic and treatment services. Eligible women can apply to Utah B&C by calling 800-717-1811 or by submitting an online enrollment form available at: [https://cancerutah.org/do-i-qualify/]. The Utah Cancer Coalition is a statewide partnership whose goal is to reduce the burden of cancer. The mission of the coalition is to lower cancer incidence and mortality in Utah through collaborative efforts directed toward cancer prevention and control. As a result of this planning process, objectives and strategies have been developed by community partners regarding the early detection of cervical, testicular, prostate, skin, breast, and colorectal cancers as well as the promotion of physical activity, healthy eating habits, and smoking cessation.

Health Program Information

In 1980, the Utah Department of Health and Human Services began providing clinical breast exams and a sliding fee scale. In 1993, state funding was appropriated for mammography. That same year, the Utah Breast and Cervical Cancer Program (Utah B&C) first received a capacity-building grant from the Centers for Disease Control and Prevention (CDC) to conduct breast and cervical cancer screening in Utah. A comprehensive grant was awarded to the program in 1994 to continue breast and cervical cancer screening. Since 1994, Utah B&C and partners, including local health departments, mammography facilities, pathology laboratories, and private providers, have worked together to ensure the appropriate and timely provision of clinical services. Utah B&C continues to receive funding from the CDC for breast and cervical cancer screening.