Many U.S. women undergo annual mammograms despite guideline recommendations
More than 75% of women received a mammogram in the past year, suggesting that a large proportion of women undergo screening annually regardless of guideline recommendations for biennial screening, according to the 2019 and 2021 National Health Interview Survey.
A high proportion of U.S. women who undergo mammograms do so annually, despite some guidelines recommending biennial screening, a study found.
To assess how often U.S. women ages 40 to 84 years reported mammography screening in the past year versus the past one to two years, investigators analyzed data from the 2019 and 2021 National Health Interview Survey. The sample adult response rate was 59.1% in 2019 and 50.9% in 2021, for a final sample of 20,034 women. The average participant age was 58.7 years, 66.1% of women were non-Hispanic White, and none had a history of breast cancer. Findings were published as a brief research report by Annals of Internal Medicine on March 25.
A total of 68.1% (95% CI, 67.2% to 68.9%) of participants reported mammography screening in the past two years; 75.2% (95% CI, 74.3% to 76.1%) of that group reported screening in the past year. Among women who reported screening in the past two years, those ages 40 to 44 years and 55 to 74 years were more likely to report screening in the past year than women ages 45 to 54 years or 75 to 84 years. Being non-Hispanic Black; having a college degree, private insurance, or higher income; and being from the Northeast or Midwest and married were associated with being screened within a year. In addition, women who reported a wellness visit or physical in the past year or those who were surveyed in 2019 were also more likely to report screening in the past year. Among those ages 65 to 84 years with less than a 10-year life expectancy, 71.1% (95% CI, 68.5% to 73.8%) screened in the last two years reported screening in the past year.
Limitations to the study include a lack of information on whether patients were adhering to physician recommendations.
“Although most guidelines recommend shared decision making or discontinuation of screening when life expectancy is less than 10 years or for women aged 75 years or older, many of these women also reported screening in the past year rather than the past 1 to 2 years, suggesting that many of these women continue screening annually,” the study authors wrote. The results also suggest that future interventions to improve breast cancer outcomes for non-Hispanic Black women should focus on follow-up testing and treatment rather than screening, they added.
“Multilevel interventions to inform women aged 40 years or older of the option to screen biennially may be appropriate for health system or programs choosing to follow guidelines recommending biennial screening,” the authors concluded.
An accompanying editorial highlighted reasons why screening adherence to biennial screening at ages 55 to 74 years is not higher, including wide variations across recommended ages to start and stop screening and in intervals between screening.
The editorialists also noted that the study called “particular attention to areas of potential overuse of mammography, including annual versus biennial intervals and screening after the age at which early detection would confer a mortality benefit given competing cause of death.”