Health Indicator Report of Breast Cancer Screening (Mammography)
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.''
Mammogram Within the Past Two Years, Utah and U.S., 1989-2019
NotesAge-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.
- 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
Data Interpretation IssuesIn 2016, age distribution was changed from 8 groupings to 5 groupings; this may affect the interpretation of data trends.
DefinitionThe proportion of women 40 years or older who reported having a mammogram in the last two years.
NumeratorThe number of women 40 years or older who reported having a mammogram in the last two years.
DenominatorThe total number of female survey respondents aged 40 or older excluding those who responded "don't know" or "refused" to the numerator question.
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 ObjectivesCSTE 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 ServicesThe 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.
Page Content Updated On 10/15/2020, Published on 12/21/2020