Public health focus: mammography.

Among U.S. women, breast cancer is the most commonly diagnosed cancer and the second leading cause of death from cancer. From 1980 through 1987, the incidence of breast cancer increased from 94.6 to 124.3 per 100,000 women (age-adjusted to the 1990 U.S. population) (1). In contrast, death rates remained stable; during 1988, 31.1 per 100,000 U.S. women died from the disease (Table 1) (2,3). Although the prognosis for breast cancer is more favorable than for many other types of cancers, breast cancer continues to be an important source of years of potential life lost before age 65 (YPLL) (Table 1). White women account for 82% of all YPLL from breast cancer; however, the estimated rate of YPLL during 1988 was approximately 25% higher for black women than white women. For breast cancer, certain primary risk factors (e.g., family history, age at menarche, and age at menopause) cannot be altered and others (e.g., parity and age at first pregnancy) are not practical targets for intervention. Therefore, as a secondary method for prevention of breast cancer, mammography screening is the most commonly recommended intervention. During 1990, 58% of U.S. women aged greater than or equal to 40 years reported having had a screening mammogram within the preceding 2 years (Figure 1). This report summarizes information regarding the efficacy, effectiveness, and cost-effectiveness of mammography screening.