Trends in Mammography and Clinical Breast Examination: A Population-Based Study

Background

There are well-accepted clinical guidelines for early detection of breast cancer through mammography and clinical breast examination. The purpose of this study was to determine trends in the utilization of these techniques over the past 5 years.

Methods

The National Health Interview Survey is a population-based computer survey of noninstitutionalized civilian Americans conducted annually by the National Center for Health Statistics, Centers for Disease Control and Prevention. We evaluated the reported use of mammography and clinical breast examination in women 40 years of age and older between 2000 and 2005. Data were evaluated using SAS and SAS-callable SUDAAN software.

Results

Surveyed were 10,994 and 11,128 women over age 40 in 2000 and 2005, respectively. Between these years, there was a decline in women ≥40 years old who reported ever having a mammogram (80.79% versus 79.52%, P < 0.0001) and in those who had a mammogram within the preceding 2 years (87.98% versus 86.30%, P = 0.0040). In addition, there was a drop in women reporting ever having a clinical breast exam (82.12% versus 75.91%, P < 0.0001) and in those reporting having had a clinical breast exam in the 2 years prior to the survey (89.24% versus 87.63%, P = 0.0012). Similar results were found in the population aged 50–69.

Conclusions

Despite well-established clinical guidelines for early detection of breast cancer, there has been a decline in the rates of annual mammography and clinical breast exam in women over the age of 40 over the past 5 years.

Key Words: mammography, breast examination, screening, trends, survey