Vital signs: breast cancer screening among women aged 50-74 years - United States, 2008.

BACKGROUND

Breast cancer remains the second leading cause of cancer deaths for women in the United States. Screening with treatment has lowered breast cancer mortality.

METHODS

Every 2 years, CDC uses Behavioral Risk Factor Surveillance System data to estimate mammography prevalence in the United States. Up-to-date mammography prevalence is calculated for women aged 50-74 years who report they had the test in the preceding 2 years.

RESULTS

For 2008, overall, age-adjusted, up-to-date mammography prevalence for U.S. women aged 50-74 years was 81.1%, compared with 81.5% in 2006. Among the lowest prevalences reported were those by women aged 50-59 years (79.9%), persons who did not finish high school (72.6%), American Indian/Alaska Natives (70.4%), those with annual household income <$15,000 (69.4%), and those without health insurance (56.3%). Highest mammography prevalence was among residents of the northeastern United States.

CONCLUSIONS

In recent years, mammography rates have plateaued. Critical gaps in screening remain for certain racial/ethnic groups and lower socioeconomic groups, and for the uninsured.

IMPLICATIONS FOR PUBLIC HEALTH PRACTICE

Health-care reform is likely to increase access by increasing insurance coverage and by reducing out-of-pocket costs for mammography screening. Widespread implementation of evidence-based interventions also will be needed to increase screening rates. These include patient and provider reminders to schedule a mammogram, use of small media (e.g., videos, letters, brochures, and flyers), one-on-one education of women, and reduction of structural barriers (e.g., more convenient hours and attention to language, health literacy, and cultural factors).