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SALT LAKE CITY — Despite breast cancer being the leading cancer death in Utah women, the Department of Health and Human Services reported the state failed to meet its goal of screening 76% of Utah women aged 40 or older by 2020.
Screening tools such as a mammography have been shown to reduce breast cancer mortality rates and can increase the chance of early detection and treatment. While mammography screenings are considered a critical tool, not all women receive screenings and some can face barriers in accessing them.
Utah ranks among the three lowest states for breast cancer screening rates in women age 40 years or older, according to data from the latest Behavioral Risk Factor Surveillance System. Only 62.7% of Utah women in the age group reported receiving a mammography in the last two years, with the average screening rate for U.S. women in the same group being 69%.
While breast cancer incidence rates are lower in Utah than the national rate, screening rates have continued to drop and pose a threat to the health of Utah women. A new report by the Utah Women and Leadership Project provides an overview of breast cancer and mammography rates for women in Utah, an analysis on the issues contributing to low screening rates and solutions to improve screening rates.
"We really do want to see women starting to do this preventative care early on," said Emily Darowski, associate director of the Utah Women and Leadership Project. "Mammograms are an essential screening tool. They can reduce breast cancer mortality because they can help us with early detection and therefore early treatment for women."
Demographics and disparities
The report released by the Utah Women and Leadership Project is an update to a previous report done by the group in 2017. The new brief followed and compared previous trends observed in the original report using new data from the Utah Department of Health's Public Indicator Based Information System and Behavioral Risk Factor Surveillance System.
The updated trends included age, ethnicity and race, income, education and location:
- Age — Women age 40-49 were significantly less likely to have received a mammogram compared to women in older age groups from 2019 to 2020. The trend is similar to numbers reported in the 2017 report, but the current rates of the two older groups have since slightly decreased.
- Ethnicity and race — There was no significant difference in mammography rates between women who identified as either Hispanic or non-Hispanic in 2020, according to the report. White women recorded the lowest screening rates at 62.8% from 2018 to 2020. The largest change in the data was an increase in screening rates for Native American women by 10.9%.
- Income — A pattern of higher screening rates being associated with women who receive higher incomes was seen in both snapshots. Screening rates for lower-income women did increase between the two reports by 4%.
- Education — Similarly to income, women with higher education levels were associated with higher screening rates. Screening rates for women who've received only a high school diploma or a General Education Development certificate fell by 4.1%.
- Location — Mammography rates were higher in small areas with lower health disparities: 68.9% in very low health disparities areas, 62.1% in low areas, 67.5% in average areas, 57.6% in high areas, and 56.2% in very high health disparities areas, according to the Utah Department of Health and Human Services' Health Improvement Index.
"The Utah Department of Health has developed a Health Improvement Index, and it helps assess which small areas in Utah have greater health disparities," Darowski explained. "I think this just informs us that we need to make sure that we're targeting those areas with messaging about this kind of preventative care."
What Utahns can do
To help improve rates of screening, the report offers the following solutions:
- Establishing clear, consistent guidelines and goals between U.S. agencies, state agencies and health care professionals.
- Utah health care and insurance systems building patient advisories into electronic record systems and tracking how often providers remind individuals to stay current on preventive care, including mammograms.
- Utah employers implementing screening initiatives to encourage employees to complete screenings according to recommended age and frequency guidelines. Employers can also work to remove schedule conflicts or related barriers for employees to access screening more easily.
- Implementing the Utah Comprehensive Cancer Control Program and the Utah Cancer Action Network 2021–2025 Utah Comprehensive Cancer Prevention and Control Plan, which outlines the following priorities: Increase food security in the state; create healthy neighborhood environments; improve access to high-quality health care services for all; and reduce financial toxicity among cancer survivors.
- Health and government organizations continuing to support public awareness campaigns in Utah, as a recent study showed a significant increase (180.1%) in the volume of related internet searches surrounding Breast Cancer Awareness Month.
"We may need to see greater access to programs so that we get to those people who maybe are hesitant or maybe can't travel or are unsure about how to do this," said Darowski.
