UT-EPHT - Health Indicator Report - Breast Cancer Screening (Mammography)

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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

1. Myers ER, Moorman P, Gierisch JM, et al. Benefits and harms of breast cancer screening. JAMA. doi:10.1001/jama.2015.13183.
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.
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.

Graph

Data Table

	BRFSS Utah vs. U.S. Series Value	BRFSS Utah vs. U.S.	Year	Age-adjusted Percentage of Women Age 40+	Lower 95% CI	Upper 95% CI
UT Old Methodology
	1	UT Old Methodology	1989	51.6%	46.6%	56.5%
	1	UT Old Methodology	1990	54.8%	50.0%	59.5%
	1	UT Old Methodology	1991	57.9%	53.1%	62.8%
	1	UT Old Methodology	1992	64.0%	59.7%	68.3%
	1	UT Old Methodology	1993	61.6%	56.9%	66.2%
	1	UT Old Methodology	1994	67.4%	62.7%	72.0%
	1	UT Old Methodology	1995	63.1%	58.9%	67.3%
	1	UT Old Methodology	1996	64.4%	60.7%	68.2%
	1	UT Old Methodology	1997	65.0%	60.7%	69.3%
	1	UT Old Methodology	1998	65.7%	61.3%	70.1%
	1	UT Old Methodology	1999	67.3%	63.3%	71.3%
	1	UT Old Methodology	2000	72.6%	68.9%	76.3%
	1	UT Old Methodology	2002	68.8%	65.5%	72.0%
	1	UT Old Methodology	2004	66.4%	63.7%	69.1%
	1	UT Old Methodology	2006	67.8%	65.3%	70.2%
	1	UT Old Methodology	2008	67.2%	64.5%	69.8%
	1	UT Old Methodology	2010	66.4%	64.5%	68.2%
	1	UT Old Methodology	2011		n/a	n/a
	1	UT Old Methodology	2012		n/a	n/a
	1	UT Old Methodology	2013		n/a	n/a
	1	UT Old Methodology	2014		n/a	n/a
	1	UT Old Methodology	2016		n/a	n/a
	1	UT Old Methodology	2018		n/a	n/a
	1	UT Old Methodology	2019		n/a	n/a
	1	UT Old Methodology	2020		n/a	n/a
	1	UT Old Methodology	2022		n/a	n/a
US Old Methodology
	2	US Old Methodology	1989	55.2%	54.1%	56.3%
	2	US Old Methodology	1990	58.8%	57.7%	59.8%
	2	US Old Methodology	1991	63.2%	62.3%	64.1%
	2	US Old Methodology	1992	63.5%	62.7%	64.3%
	2	US Old Methodology	1993	66.8%	56.9%	66.2%
	2	US Old Methodology	1994	66.8%	66.0%	67.5%
	2	US Old Methodology	1995	69.8%	69.0%	70.5%
	2	US Old Methodology	1996	70.0%	69.3%	70.6%
	2	US Old Methodology	1997	71.1%	70.4%	71.7%
	2	US Old Methodology	1998	72.3%	71.0%	73.7%
	2	US Old Methodology	1999	74.1%	73.5%	74.6%
	2	US Old Methodology	2000	76.6%	76.0%	77.1%
	2	US Old Methodology	2002	76.0%	75.4%	76.5%
	2	US Old Methodology	2004	74.2%	73.8%	74.7%
	2	US Old Methodology	2006	76.1%	75.7%	76.6%
	2	US Old Methodology	2008	76.2%	75.9%	76.6%
	2	US Old Methodology	2010	74.9%	74.5%	75.2%
	2	US Old Methodology	2011		n/a	n/a
	2	US Old Methodology	2012		n/a	n/a
	2	US Old Methodology	2013		n/a	n/a
	2	US Old Methodology	2014		n/a	n/a
	2	US Old Methodology	2016		n/a	n/a
	2	US Old Methodology	2018		n/a	n/a
	2	US Old Methodology	2019		n/a	n/a
	2	US Old Methodology	2020		n/a	n/a
	2	US Old Methodology	2022		n/a	n/a
UT New Methodology
	3	UT New Methodology	1989		n/a	n/a
	3	UT New Methodology	1990		n/a	n/a
	3	UT New Methodology	1991		n/a	n/a
	3	UT New Methodology	1992		n/a	n/a
	3	UT New Methodology	1993		n/a	n/a
	3	UT New Methodology	1994		n/a	n/a
	3	UT New Methodology	1995		n/a	n/a
	3	UT New Methodology	1996		n/a	n/a
	3	UT New Methodology	1997		n/a	n/a
	3	UT New Methodology	1998		n/a	n/a
	3	UT New Methodology	1999		n/a	n/a
	3	UT New Methodology	2000		n/a	n/a
	3	UT New Methodology	2002		n/a	n/a
	3	UT New Methodology	2004		n/a	n/a
	3	UT New Methodology	2006		n/a	n/a
	3	UT New Methodology	2008		n/a	n/a
	3	UT New Methodology	2010	64.5%	62.6%	66.4%
	3	UT New Methodology	2011	67.2%	64.4%	69.9%
	3	UT New Methodology	2012	68.0%	66.2%	69.7%
	3	UT New Methodology	2013	66.6%	63.7%	69.4%
	3	UT New Methodology	2014	64.8%	63.1%	66.4%
	3	UT New Methodology	2016	65.4%	63.3%	67.5%
	3	UT New Methodology	2018	63.1%	61.0%	65.1%
	3	UT New Methodology	2019	63.8%	60.9%	66.6%
	3	UT New Methodology	2020	62.7%	60.6%	64.7%
	3	UT New Methodology	2022	63.8%	61.6%	65.9%
US New Methodology
	4	US New Methodology	1989		n/a	n/a
	4	US New Methodology	1990		n/a	n/a
	4	US New Methodology	1991		n/a	n/a
	4	US New Methodology	1992		n/a	n/a
	4	US New Methodology	1993		n/a	n/a
	4	US New Methodology	1994		n/a	n/a
	4	US New Methodology	1995		n/a	n/a
	4	US New Methodology	1996		n/a	n/a
	4	US New Methodology	1997		n/a	n/a
	4	US New Methodology	1998		n/a	n/a
	4	US New Methodology	1999		n/a	n/a
	4	US New Methodology	2000		n/a	n/a
	4	US New Methodology	2002		n/a	n/a
	4	US New Methodology	2004		n/a	n/a
	4	US New Methodology	2006		n/a	n/a
	4	US New Methodology	2008		n/a	n/a
	4	US New Methodology	2010		n/a	n/a
	4	US New Methodology	2011		n/a	n/a
	4	US New Methodology	2012	73.2%	72.8%	73.7%
	4	US New Methodology	2013		n/a	n/a
	4	US New Methodology	2014	72.5%	72.1%	72.9%
	4	US New Methodology	2016	71.0%	70.5%	71.5%
	4	US New Methodology	2018	70.9%	70.3%	71.4%
	4	US New Methodology	2019		n/a	n/a
	4	US New Methodology	2020	69.0%	68.4%	69.7%
	4	US New Methodology	2022	68.2%	67.7%	68.8%

Data Notes

Notes

Age-adjusted to U.S. 2000 standard population.

Data provided for all years available.

Old Methodology: Previous BRFSS methodology used "post-stratification" which was used to weight data by age, gender, and local health district (LHD).

New Methodology: To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. It began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method. With raking, education, race/ethnicity, marital status, home ownership/renter, and telephone source are included in the weighting procedure.

Due to changes in sampling and weighting methodology, data from the new methodology represents a new baseline, and comparisons from new to old methodology data are not appropriate.

Data Sources

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html
Behavioral Risk Factor Surveillance System Survey Data, US Department of Health and Human Services Centers for Disease Control and Prevention (CDC).

Data Interpretation Issues

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

Health Indicator Definition

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.

Health Objectives and Targets

Other Objectives

CSTE Chronic Disease Indicators

Current Outlook

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.

Health Improvement Resources

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.

Available Services

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.

Page Content Updated On 03/26/2024, Published on 04/11/2024

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Health Indicator Report of Breast Cancer Screening (Mammography)