Many women bury their heads in the sand when it comes to mammography screening


Do you remember the public outcry over the recommendation that women over 50 should only have mammograms every two years? Last year, the U.S. Preventive Services Task Force, an independent panel of non-federal experts in prevention and evidence-based medicine, recommended that the age of first routine mammogram be lifted from 40 to 50 years of age, at which biennial mammography begins. This recommendation was counter to the annual standard for women over 40.We women were upset! How dare the government take away our right to be vigilant with regard to our breast health! How dare they limit screenings for women over fifty, the age group most likely to develop the disease. Marches and rallies were organized, heated debates were broadcast on national TV, and to date, no major insurance company or other organization has acted on the Task Force's recommendation.Well, guess what? Even with the backlash against the November '09 Task Force guidelines, many women (40 percent) are still not getting mammograms. "Women reacted strongly to that recommendation with protests about their right to have an annual mammogram that should not be taken away," said Milayna Subar, MD, vice president and national practice leader for oncology at Medco Health Solutions, Inc. in New Jersey. "Interestingly, though, we found that a large percentage of women do not get regular mammograms." Subar and colleagues reviewed medical claims between January 2006 and December 2009 from a database of more than 12 million people. All participating women had either employer-provided insurance or Medicare. Among those who were 40 to 85 years of age, only 50 percent had a mammogram in any given year, and only 60 percent had two or more mammograms over four years. Average annual mammography rates were 47 percent for women aged 40 to 49 years, 54 percent for women aged 50 to 64 years and 45 percent for women aged 65 years and older. The researchers didn't examine why the women weren't getting mammograms. The data presented were interesting, but to me, the reasons as to why so many insured women aren't being screened begs the larger question. I decided to conduct my own research. I asked everyone on the CURE staff to call home and ask their moms if they were getting regular mammograms (at least one every two years) and if not, why not?The results of my very unscientific poll concluded that 25 percent of CURE moms don't get regular mammograms. All are insured. The reasons varied, but overall, fear and denial were the highest factors for not getting checked. One mom said that she regularly makes the excuse that she simply doesn't have the time, but in reality, she's scared to go. Another, who is 83, said she hasn't had one in 10 years because she's "too old to worry about that." One staffer said that the only reason her mom goes is because she "makes her."Of the 75 percent of moms who do get regular mammograms, most said that they do so because of personal or family cancer histories. My mom, whose own mother and both daughters have all battled breast cancer said, "I go every December because I'm supposed to." She added, "I have a friend who had a lump biopsied years ago. It was benign. She hasn't been back since. I think she's playing ostrich."What about you? Are you getting regular mammograms? If not, why not?

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