Survey: Mammogram access declining for women younger than 50

SAN FRANCISCO — Women ages 40 to 49 have less access to mammograms in some states since the U.S. Preventive Services Task Force released its recommendations to change breast cancer screening guidelines last November, according to a recent online survey conducted by the Avon Foundation for Women.

The USPSTF recommended changing the current mammography screening guidelines for average risk women to begin biennial screening at age 50 instead of annual mammograms starting at age 40.

The survey included more than 150 breast cancer health educators and providers from 48 states and the District of Columbia, all of which are Avon Foundation grant recipients.

“Our survey gives us an early indication from those working on the front lines of breast cancer education, screening and treatment as to how the recommended guidelines may be affecting their work,” said Marc Hurlbert, director of the Avon Foundation Breast Cancer Crusade.

Respondents from 25 percent of the states represented in the nationwide survey report changes in their states’ Breast and Cervical Cancer Early Detection programs. According to these respondents, the USPSTF-recommended guidelines combined with other factors, such as budget cuts, have resulted in fewer mammograms or the elimination of early screening programs for women younger than 50 offered through state-administered breast cancer screening programs.

According to respondents, California, New York, Florida, Illinois and Michigan are among those states that have made changes in their state’s breast cancer screening programs since the USPSTF released its guidelines.

“Budget cuts are a reality, but we are concerned that the new USPSTF guidelines may be making it easier for state government-funded programs to stop providing mammograms to women under the age of 50 who may need to be screened,” said Barbara Cicerelli, health program coordinator for the San Francisco Department of Public Health.

In addition to limiting access, the USPSTF-recommended guidelines may be the reason fewer women younger than 50 are seeking mammograms. Twenty-four percent of survey respondents report a decrease in the number of women younger than 50 being screened or seeking appointments for mammograms at their facilities. According to some of these survey respondents, many women who were already reluctant to have a mammogram are using the guidelines as their rationale to put off screening.

“We are concerned that some women may simply accept the new recommended guidelines as standard — not taking into consideration their own health history and other breast cancer risk factors,” Hurlbert said.

The new USPSTF recommendations address limitations with current mammography technology and the level of scientific understanding about breast cancer disease progression, aggressiveness, and likelihood of metastasis. The Avon Foundation for Women along with other expert groups, including the American Cancer Society, American College of Radiology and Susan G. Komen for the Cure, supports current mammography guidelines starting screening at age 40 until better alternatives are developed.