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Study finds mammograms not as frequent as thought

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U.S. women might not be getting screening mammograms as frequently as previously thought, a study suggests today.

Most breast cancer experts advise that women 40 and older get mammograms every year or two. Prior research based on surveys of women had suggested that about four out of five U.S. women in that age group follow that breast cancer screening recommendation.

Instead of simply asking women how often they get mammograms, the new study used a database of actual visits to 40 of New Hampshire's 44 mammography facilities.

The researchers concluded that only about two-thirds of New Hampshire women 40 and older get mammograms every one or two years. Yet 97% have health insurance and 61% went to college -- two attributes linked to higher rates of preventive health care.

"We ought to be doing better than this," says lead author Patricia Carney, who until last week was co-director of the cancer control program at Dartmouth's Norris Cotton Cancer Center. Next week, she joins the Oregon Health Sciences University's Cancer Institute.

Trials in which women were randomly assigned to mammography or no mammography have found that screening cuts breast cancer death rates 30% in women 50 and older and 17% in women in their 40s, Carney says.

"It does miss some cancers," Carney says. But, she says, mammography has "vastly improved" as a result of the 1992 federal Mammography Quality Standards Act. "The imaging is much better in the U.S. than it's ever been. Women are exposed to less radiation than they've ever been exposed to."

Then why aren't women getting mammograms as frequently as recommended? "I do think women are confused about how often they need to get a mammogram," Carney says.

A big part of the problem is that women either don't have an established relationship with a primary-care doctor or, if they do, their doctors aren't reminding them to get mammograms, says Robert Smith, director of screening for the American Cancer Society. Smith suggests women take the initiative and designate a month for their annual or biennial mammograms.

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