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Senior Citizen Health & Medicine
Older Women Have Far Fewer Mammograms Than They
Report
By Joel R. Cooper, Contributing Writer
Health Behavior News Service
June 20, 2006 - What older American women say about
receiving regular mammograms and what they actually do are two different
things, suggests a new study.
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And unlike prior studies based on patient
self-reports of mammography screening, the new study suggests that older
African-American, Asian-American and Hispanic women all receive less
screening than do white women.
The rate of screening mammography among elderly
American women is significantly lower than what has been reported based
on the self-reported data sources said lead author Christopher Kagay,
M.D. Yet, he said, these inflated rates are the most frequently cited
data by policy makers.
The study, to be published in the August issue of
the American Journal of Preventive Medicine, analyzed national Medicare
data involving 146,669 women ages and older. Researchers compared these
data to patient self-reports collected by the Behavioral Risk Factor
Surveillance System and the National Health Interview Study. The data
were amassed between 1991 and 2001.
The screening rate for most groups of non-white
women is substantially lower than that for white women, even while
adjusting for factors of health status, access to care, education and
income, said Kagay, a radiology resident at Massachusetts General
Hospital and a clinical fellow at Harvard Medical School.
Self-reported studies of mammography screening had
suggested that there were no significant differences in screening
frequency by race our study found just the opposite, Kagay said.
While self-reported studies suggested that as many
as 70 percent to 80 percent of women ages 65 to 69 received at least one
mammogram every two years, the new study paints a far less rosy picture
with just 61.1 percent of women in this age group overall receiving
regular screening, and even lower rates seen among older
African-American, Asian-American and Hispanic women.
The study was not designed to illuminate the
reasons for the gap between actual mammograms received and self-reported
data only to measure it. But Kagay surmises that several factors may
be at play.
Some respondents may misremember a screening
mammogram from, for example, three years ago as having occurred more
recently than it actually did, he said. Alternatively, some women may
know that they should be screened, and may therefore unconsciously
tend to over-report their own screening.
The study has practical clinical implications for
physicians, according to Kagay. Were not as close to our goal of
screening all the elderly women who might be able to benefit from breast
cancer therapy as we thought we were. Thats feedback referring
physicians can use as they assess their own referral patterns.
This study highlights once again the need for
awareness and education about the benefits of screening, especially in
the aging population where the risk for breast cancer is the greatest,
said Cheryl Perkins, M.D., senior clinical advisor for the Susan G.
Komen Breast Cancer Foundation.
By examining data from Medicare, this study has
highlighted the differences between data interpretation based on
clinical records versus self-reported data, said Perkins.
Self-reported data may inaccurately represent the true screening levels
in a given population.
These findings could have significant impact on
how we interpret future population data, she added.
Breast cancer is the most common cancer of women in
the United States, affecting more than 211,000 American females each
year. Deaths from breast cancer are highest in women under 35 and in
women older than 75. Yet it is predominantly a disease of older women,
with a womans chances of getting breast cancer increasing as she ages.
If more women were screened, it is possible that
more breast cancer would be discovered, and it could be treated at an
earlier stage when the chances of a good outcome would be enhanced in
women otherwise healthy enough to undergo treatment, Kagay said.
The Breast Cancer Foundation recommends annual
screening mammography for women ages 40 and older.
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