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Annual mammograms among breast cancer survivors on the decline

par John R. Fischer, Senior Reporter | April 22, 2022
Women's Health
Breast cancer survivors have been less frequently getting mammograms since 2009.
Annual mammography screenings have been slipping since 2009 among breast cancer survivors, particularly young ones.

Researchers across the U.S. say that rates for those between 50 and 64 were 74% from 2004 to 2009, but fell to 67% in 2016. Among those 40 to 49, it fell from 70% to 57%. Annual mammography rates all together dropped approximately 1.5% per year from 2009 to 2016. The rate of decline among 40 to 49-year-olds was 2.8%.

The study was conducted prior to the COVID-19 pandemic, which has only continued to hinder cancer screenings, according to the authors. They say that the findings may indicate a knowledge gap of the significance of annual mammograms, especially among younger patients, who are more likely to develop aggressive tumors and have a longer remaining life expectancy.

“I was surprised that we saw declines in mammography use among patients who were continuing to see their cancer specialists. It suggests we are seeing less frequent mammography participation even among those who are otherwise engaged in their cancer care,” said lead researcher Dr. Kathryn Lowry, assistant professor of radiology at the University of Washington School of Medicine, in a statement.

She added that there needs to be “additional studies to better understand the barriers that are leading to fewer mammograms.”

The study took into account recency of surgery or primary care visits, neighborhood racial and socioeconomic demographics, geographic region and deductible costs. But data was not conclusive on which specific factors are responsible for the decline.

The authors contend that more qualitative interviews will help better determine the obstacles to care and tactics for ensuring survivors undergo annual mammograms routinely. One way, proposed by author Dr. Amy Sitapati of UC San Diego Moores Cancer Center and a member of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Panel for Breast Cancer, is to use EMR-based registries for long-term follow-up.

“In today’s systems and informatics-based records, we are not strategically prioritizing and reaching out to survivors using standardized and highly reliable processes,” she said. “The downward trend in adherence to annual mammography in survivorship should serve as a call to action for new processes that identify and engage breast cancer survivors.”

The findings were published in the April 2022 edition of JNCCN–Journal of the National Comprehensive Cancer Network.

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