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Complete Health Indicator Report of Breast Cancer Screening (Mammography)

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.

Data Interpretation Issues

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

Why Is This Important?

Breast cancer is the most commonly occurring cancer in U.S. women (excluding basal and squamous cell skin cancers). It is also 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. Clinical trials and observational studies have demonstrated that routine screening with mammography can reduce breast cancer mortality by about 20% for women of average risk.^1^[[br]] [[br]] '''Breast Cancer Screening Recommendations (American Cancer Society):'''[[br]] __Before Age 40__: Women who are at higher than average risk of breast cancer (due to family history of breast cancer, BRCA 1 or 2 genetic mutations, or who received thoracic irradiation between the ages of 10 and 30) should seek expert medical advice about whether they should begin screening before age 40 and the frequency of that screening.[[br]] __Age 40-44__: Women with average risk of developing breast cancer may consider being screened annually for breast cancer. Women at higher risk should consult with their physician.[[br]] __Age 45-54__: Women with average risk of developing breast cancer should be screened annually for breast cancer. Women at higher risk should consult with their physician.[[br]] __Age 55-75__: Women with average risk of developing breast cancer may be screened annually or biennially for breast cancer. Women at higher risk should consult with their physician.[[br]] __Age 76+__: Annual or biennial breast cancer screening should continue for women who are in good health and who are expected to live an additional 10+ years. [[br]] [[br]] If you are age 40 or over, or have a family history of breast cancer, talk to your doctor about the best screening guidelines for you.[[br]] [[br]] ---- ''1. Myers ER, Moorman P, Gierisch JM, et al. Benefits and harms of breast cancer screening. JAMA. doi:10.1001/jama.2015.13183.''

Healthy People Objective C-17:

Increase the proportion of women who receive a breast cancer screening based on the most recent guidelines
U.S. Target: 81.1 percent
State Target: 76 percent

Other Objectives

CSTE Chronic Disease Indicators

How Are We Doing?

Between 1989 and 2019, the percentage of Utah women aged 40 or older who reported receiving a mammogram within the last two years increased from 51.6% to 64%. Although rates have increased some over time, the rate in Utah still falls far below the national average. The 2018 breast cancer screening rate in Utah was 63.1%, compared to the U.S. rate of 70.9%. In 2019, San Juan Local Health District had significantly lower mammography rates than the rest of the state (41% in San Juan compared to 64% statewide). 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 2016, 2018, and 2019. Mammography rates generally tend to increase as age of the woman, education level of the woman, and amount of household income increases. In 2018 and 2019 combined, women age 40-49 had significantly lower rates of mammography screening (52.6%) than older women (64.6%; most likely due to differing guidelines concerning the age at which breast cancer screening should begin). Looking at the highest level of education completed for the same time period, college graduates were significantly more likely to have received a mammogram (68.5%) than the general population (63.5%). 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 (55%) compared to other women, whereas women in households with an annual income of more than $75,000 were significantly more likely to have had a mammogram in the past two years (70%).

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 70.9% in 2018. Since 1994, the percentage of Utah women aged 40 or older who reported receiving a mammogram has been below the U.S. rate. In 2018, based on new survey methodology, only 63.1% of Utah women aged 40 and older had received a mammogram in the last two years compared with 70.9% of U.S. women.

What Is Being Done?

The Utah Cancer Control Program (UCCP) in the Utah Department of Health (UDOH) provides free breast cancer screening and diagnostics to uninsured or under-insured women ages 40-74 years whose income is at or below the 250% federal poverty level. Women in need of cancer treatment are enrolled into Medicaid as per the Breast and Cervical Cancer Treatment Act. In addition to providing care to under-served women, the UCCP works with health-systems to implement evidence-based practices to improve cancer screening rates. Visit [http://www.cancerutah.org] for more information or to see if you qualify for free mammography services. In addition, the UCCP initiated the Utah Cancer Action Network (UCAN), a statewide partnership whose goal is to reduce the burden of cancer. The mission of the UCAN 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

The Utah Cancer Control Program (UCCP) in the Utah Department of Health (UDOH) provides free breast cancer screening to uninsured or under-insured women ages 40 and older who are at or below the 250% federal poverty level. Women in need of cancer treatment are enrolled into Medicaid as per the Breast and Cervical Cancer Treatment Act. Visit [http://www.cancerutah.org] or call 1-800-717-1811 for more information or to see if you qualify for free mammography services.


Related Indicators

Relevant Population Characteristics

Routine screening for breast cancer with mammography has been identified as a priority issue for women 40 years of age or older by several health organizations.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

According to data collected by the Utah Behavioral Risk Factor Surveillance System, use of mammography is lower among women without health insurance compared to women with health insurance. Mammography is a preventive service covered by Medicare.

Related Health Care System Factors Indicators:


Risk Factors

The most important risk factor for breast cancer is increasing age. Other established risk factors include personal or family history of breast cancer, history of abnormal breast biopsy, genetic alterations, early age at onset of menses, late age at onset of menopause, never having children or having a first live birth at age 30 or older, and history of exposure to high dose radiation. Associations have also been suggested between breast cancer and oral contraceptives, long-term use of hormone replacement therapy, obesity (in post-menopausal women), alcohol, and a diet high in fat. Some studies suggest that exercise in youth might give life-long protection against breast cancer and that even moderate physical activity as an adult could lower breast cancer risk. More research is needed to confirm these findings.

Related Risk Factors Indicators:


Health Status Outcomes

Routine screening with mammography is an important tool in the early detection of breast cancer and early detection can save lives.

Related Health Status Outcomes Indicators:




Graphical Data Views

Mammogram Within the Past Two Years, Utah and U.S., 1989-2019

::chart - missing::
confidence limits

BRFSS Utah vs. U.S.YearAge-adjusted Percentage of Women Age 40+Lower LimitUpper Limit
Record Count: 46
UT Old Methodology198951.6%46.6%56.5%
UT Old Methodology199054.8%50.0%59.5%
UT Old Methodology199157.9%53.1%62.8%
UT Old Methodology199264.0%59.7%68.3%
UT Old Methodology199361.6%56.9%66.2%
UT Old Methodology199467.4%62.7%72.0%
UT Old Methodology199563.1%58.9%67.3%
UT Old Methodology199664.4%60.7%68.2%
UT Old Methodology199765.0%60.7%69.3%
UT Old Methodology199865.7%61.3%70.1%
UT Old Methodology199967.3%63.3%71.3%
UT Old Methodology200072.6%68.9%76.3%
UT Old Methodology200268.8%65.5%72.0%
UT Old Methodology200466.4%63.7%69.1%
UT Old Methodology200667.8%65.3%70.2%
UT Old Methodology200867.2%64.5%69.8%
UT Old Methodology201066.4%64.5%68.2%
US Old Methodology198955.2%54.1%56.3%
US Old Methodology199058.8%57.7%59.8%
US Old Methodology199163.2%62.3%64.1%
US Old Methodology199263.5%62.7%64.3%
US Old Methodology199366.8%56.9%66.2%
US Old Methodology199466.8%66.0%67.5%
US Old Methodology199569.8%69.0%70.5%
US Old Methodology199670.0%69.3%70.6%
US Old Methodology199771.1%70.4%71.7%
US Old Methodology199872.3%71.0%73.7%
US Old Methodology199974.1%73.5%74.6%
US Old Methodology200076.6%76.0%77.1%
US Old Methodology200276.0%75.4%76.5%
US Old Methodology200474.2%73.8%74.7%
US Old Methodology200676.1%75.7%76.6%
US Old Methodology200876.2%75.9%76.6%
US Old Methodology201074.9%74.5%75.2%
UT New Methodology201064.5%62.6%66.4%
UT New Methodology201166.8%64.0%69.5%
UT New Methodology201268.0%66.2%69.7%
UT New Methodology201366.2%63.5%68.9%
UT New Methodology201464.8%63.1%66.4%
UT New Methodology201665.4%63.3%67.5%
UT New Methodology201863.1%61.0%65.1%
UT New Methodology201964.0%61.1%66.7%
US New Methodology201273.2%72.8%73.7%
US New Methodology201472.5%72.1%72.9%
US New Methodology201671.0%70.5%71.5%
US New Methodology201870.9%70.3%71.4%

Data 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 Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health
  • U.S. Data: Behavioral Risk Factor Surveillance System (BRFSS), Division of Behavioral Surveillance, CDC Office of Surveillance, Epidemiology, and Laboratory Services


Mammogram Within the Past Two Years by Local Health District, Utah, 2019

::chart - missing::
confidence limits

Local Health DistrictAge-adjusted Percentage of Women Age 40+Lower LimitUpper Limit
Record Count: 14
Bear River72.7%61.3%81.7%
Central53.7%42.6%64.4%
Davis County63.0%54.4%70.9%
Salt Lake County67.6%62.2%72.5%
San Juan40.9%27.0%56.3%
Southeast60.6%43.1%75.8%
Southwest56.5%46.5%66.1%
Summit73.3%55.5%85.8%
Tooele60.5%45.2%73.9%
TriCounty59.2%44.8%72.3%
Utah County57.8%51.4%64.0%
Wasatch69.4%54.2%81.4%
Weber-Morgan69.2%59.8%77.2%
State of Utah64.0%61.1%66.7%

Data Notes

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

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Mammogram Within the Past Two Years by Utah Small Area, 2018 and 2019

::chart - missing::
confidence limits

Utah Small AreasAge-adjusted Percentage of Women Age 40+Lower LimitUpper LimitNote
Record Count: 100
Brigham City61.8%41.5%78.7%
Box Elder Co (Other) V245.0%22.6%69.6%
Tremonton****
Logan V270.2%59.4%83.6%
North Logan65.7%40.0%84.6%*
Cache (Other)/Rich (All) V264.6%49.6%77.1%
Hyrum82.5%62.6%93.0%*
Smithfield****
Ben Lomond61.5%49.5%72.2%
Weber County (East)65.2%51.9%76.5%
Morgan County58.4%38.9%75.5%*
Ogden (Downtown)62.0%47.6%74.5%
South Ogden69.6%56.2%80.3%
Roy/Hooper77.4%61.9%87.8%
Riverdale61.8%45.8%75.5%
Clearfield Area/Hooper65.6%52.0%77.0%
Layton/South Weber50.6%39.5%61.6%
Kaysville/Fruit Heights57.3%40.8%72.2%
Syracuse81.2%64.0%91.3%*
Centerville49.3%29.3%69.6%
Farmington73.8%55.8%86.3%*
North Salt Lake60.8%38.6%79.3%
Woods Cross/West Bountiful73.4%51.3%87.8%*
Bountiful58.0%44.1%70.7%
SLC (Rose Park)72.6%56.9%84.2%
SLC (Avenues)****
SLC (Foothill/East Bench)77.0%60.7%87.9%*
Magna69.4%49.3%84.0%
SLC (Glendale) V239.7%26.1%55.1%*
West Valley (Center)49.4%31.1%67.8%
West Valley (West) V256.0%41.7%69.4%
West Valley (East) V260.9%45.3%74.5%
SLC (Downtown) V257.3%29.1%81.5%**
SLC (Southeast Liberty)52.3%31.8%72.0%
South Salt Lake53.7%38.3%68.4%*
SLC (Sugar House)56.9%39.3%72.9%
Millcreek (South)70.9%54.5%83.2%*
Millcreek (East)73.3%45.8%90.0%*
Holladay V279.8%64.1%89.7%
Cottonwood64.7%51.1%76.3%
Kearns V253.4%36.4%69.6%
Taylorsville (E)/Murray (W)68.6%55.0%79.7%
Taylorsville (West)61.9%46.0%75.6%
Murray57.2%40.3%72.6%
Midvale72.3%52.6%86.0%*
West Jordan (Northeast) V255.3%38.4%71.2%
West Jordan (Southeast)65.8%51.8%77.4%
West Jordan (W)/Copperton68.1%53.0%80.2%
South Jordan V278.1%61.3%88.9%*
Daybreak69.9%47.3%85.7%
Sandy (West)43.7%26.9%62.0%
Sandy (Center) V277.6%63.2%87.5%*
Sandy (Northeast)78.1%61.3%88.9%*
Sandy (Southeast)70.4%49.7%85.2%*
Draper76.6%62.6%86.6%
Riverton/Bluffdale73.7%60.3%83.7%
Herriman65.5%45.3%81.3%
Tooele County (Other)59.6%45.0%72.6%
Tooele Valley62.1%51.5%71.6%
Eagle Mountain/Cedar Valley69.5%50.6%83.6%
Lehi57.3%45.3%68.5%
Saratoga Springs49.1%34.5%63.9%
American Fork58.0%46.0%69.2%
Alpine45.3%31.0%60.4%*
Pleasant Grove/Lindon54.9%43.4%66.0%
Orem (North)68.0%50.3%81.7%
Orem (West)62.2%39.2%80.7%
Orem (East)77.9%59.4%89.5%*
Provo/BYU51.8%33.3%69.9%
Provo (West City Center)61.2%43.8%76.2%
Provo (East City Center)****
Salem City80.2%56.8%92.6%*
Spanish Fork65.0%51.9%76.2%
Springville70.9%54.4%83.3%
Mapleton42.4%25.5%61.3%*
Utah County (South) V268.9%55.9%79.4%*
Payson58.5%41.0%74.2%
Park City70.7%56.2%81.9%
Summit County (East)68.5%51.5%81.6%
Wasatch County65.6%53.2%76.2%
Daggett and Uintah County64.2%53.4%73.7%
Duchesne County45.8%34.2%57.8%
Nephi/Mona77.2%57.4%89.5%*
Delta/Fillmore44.0%27.8%61.6%
Sanpete Valley57.0%45.2%68.0%
Central (Other)61.4%48.9%72.5%
Richfield/Monroe/Salina47.0%35.6%58.9%
Carbon County69.2%57.7%78.8%
Emery County65.4%43.6%82.2%
Grand County58.9%35.4%78.9%*
Blanding/Monticello56.6%43.5%68.8%
San Juan County (Other)33.8%17.3%55.4%*
St. George51.1%39.6%62.5%
Washington Co (Other) V283.5%65.8%93.0%*
Washington City73.1%52.1%87.1%*
Hurricane/La Verkin58.3%38.7%75.6%
Ivins/Santa Clara72.9%42.7%90.7%*
Cedar City62.7%47.1%76.0%
Southwest LHD (Other)45.4%31.0%60.5%
State of Utah63.5%61.8%65.2%

Data Notes

Age-adjusted to U.S. 2000 standard population. *Use caution in interpreting; the estimate has a coefficient of variation > 30% and is therefore deemed unreliable by Utah Department of Health standards. **The estimate has been suppressed because 1) The relative standard error is greater than 50% or when the relative standard error can't be determined. Consider aggregating years to decrease the relative standard error and improve the reliability of the estimate. 2) the observed number of events is very small and not appropriate for publication, or 3) it could be used to calculate the number in a cell that has been suppressed. Small area groupings were changed in 2018 to better reflect the boundaries of those areas. This may affect interpretation of trend data.[[br]] Methods and changes to Utah Small Areas may be found on IBIS at the following URL: [https://ibis.health.utah.gov/resource/Guidelines.html].

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Mammogram Within the Past Two Years by Ethnicity, Utah, 2019

::chart - missing::
confidence limits

Hispanic EthnicityAge-adjusted Percentage of Women Age 40+Lower LimitUpper Limit
Record Count: 3
Hispanic65.1%52.6%75.8%
Non-Hispanic63.8%61.0%66.6%
All Utahns64.0%61.1%66.7%

Data Notes

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

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Mammogram Within the Past Two Years by Race, Utah, 2016, 2018, and 2019 combined data

::chart - missing::
confidence limits

RaceAge-adjusted Percentage of Women Age 40+Lower LimitUpper LimitNote
Record Count: 6
American Indian/Native Alaskan67.4%55.8%77.1%
Asian60.0%46.5%72.1%
Black79.5%64.4%89.2%*
Pacific Islander73.9%56.2%86.2%*
White64.1%62.7%65.4%
All Races64.2%62.8%65.5%

Data Notes

Age-adjusted to the U.S. 2000 standard population using 3 age groups. *Use caution in interpreting; the estimate has a coefficient of variation > 30% and is therefore deemed unreliable by Utah Department of Health standards. Consider aggregating years to decrease the relative standard error and improve the reliability of the estimate.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Mammogram Within the Past Two Years by Education, Utah, 2018 and 2019

::chart - missing::
confidence limits

Education LevelAge-adjusted Percentage of Women Age 40+Lower LimitUpper Limit
Record Count: 5
Less Than High School59.2%50.5%67.3%
H.S. Grad or G.E.D.60.9%57.0%64.7%
Some Post High School62.2%59.2%65.0%
College Graduate68.4%65.9%70.9%
Total63.5%61.8%65.2%

Data Notes

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

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Mammogram Within the Past Two Years by Income, Utah, 2018 and 2019

::chart - missing::
confidence limits

Income CategoryAge-adjusted Percentage of Women Age 40+Lower LimitUpper Limit
Record Count: 5
<$25,00055.1%49.6%60.5%
$25,000-$49,99958.8%53.8%63.5%
$50,000-$74,99964.0%59.7%68.1%
$75,000+70.0%67.3%72.6%
Total63.5%61.8%65.2%

Data Notes

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

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Mammogram Within the Past Two Years by Age Group, Utah, 2018 and 2019

::chart - missing::
confidence limits

Age GroupPercentage of WomenLower LimitUpper Limit
Record Count: 3
Age 40-4952.6%49.1%56.1%
Age 50-6469.5%66.7%72.1%
Age 65+70.0%67.4%72.5%

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health

References and Community Resources

Utah Cancer Control Program @ [http://www.cancerutah.org][[br]] Utah Cancer Action Network @ [http://www.ucan.cc][[br]] Susan G. Komen Foundation @ [http://www.komen.org][[br]] National Cancer Institute @ [http://www.cancer.gov][[br]] American Cancer Society @ [http://www.cancer.org][[br]] Huntsman Cancer Institute @ [http://www.huntsmancancer.org][[br]] Centers for Disease Control and Prevention @ [http://www.cdc.gov][[br]] American Society of Clinical Oncology @ [http://www.asco.org][[br]]

More Resources and Links

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

Page Content Updated On 10/15/2020, Published on 12/21/2020
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Mon, 18 January 2021 19:34:36 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Mon, 21 Dec 2020 14:47:47 MST