Hospital News

2007 Press Releases

Fewer Women Get Mammograms, and Panel Seeks to Reverse Trend

LONG BRANCH, NJ, February 2, 2007 - The number of women receiving mammograms is declining nationally and advocates of the test in New Jersey have formed a strike force to reverse a trend many find alarming.

"There is no doubt that cancers are more curable when they are found early. Mammography is still the gold standard for finding them," said Melinda Staiger, who is helping lead the American Cancer Society's mammography strike force. She also is medical director of the breast center based at Monmouth Medical Center in Long Branch.

From 2000 to 2005, the percentage of women age 40 and over who reported receiving a mammogram in the previous two years fell from 76.4 percent to 74.6 percent, says a report from the Centers for Disease Control and Prevention.

This translates into 1.44 million fewer women getting the test.

In New Jersey, the drop was almost identical to the national decline, going from 76.7 percent, to 74.9 percent.

The new strike force, made up of epidemiologists, radiologists and other experts, want to know the reasons for the decline.

Low usage of mammography has been associated with factors such as a patient's immigration status, and the lack of a primary care physician or health insurance.

Staiger said another problem may be that women are simply having difficulty accessing mammography, an X-ray picture of the breast capable of detecting cancer at an early stage, often before a lump can be felt.

In New Jersey, the number of facilities performing mammography has declined, from 278 in 2001 to 250 in 2004. Low reimbursement, along with the cost of maintaining equipment and retaining qualified personnel, are factors in the drop-off, experts say.

There are strict federal rules in place to ensure high-quality screenings, and on-site inspections focus on everything from the image quality to the qualifications and training of personnel.

In 2004, one of every four New Jersey mammogram sites failed to comply with federal rules and were cited for violations. About 75 percent of facilities were found to be in compliance the following year, however.

There has been a long-standing debate over the mammogram, with some studies showing it saves lives, while others have questioned its value. One of the most often-cited studies, sponsored by the National Cancer Institute, was published in The New England Journal of Medicine in October 2005.

It concluded that up to 65 percent of the sharp decrease in breast cancer deaths from 1990 to 2000 were due to mammograms. The rest was attributed to powerful new drug treatments.

The breast cancer mortality rate in New Jersey decreased from 34.8 per 100,000 women in 1994 to 28.5 per 100,000 women in 2003.

Still, an estimated 6,080 new cases of breast cancer will be diagnosed in New Jersey women this year, and more than 1,300 women are expected to die from the disease.

"You never get rid of a diagnostic tool until there is something better to replace it," said Barbara Waters, education and outreach manager for Susan G. Komen for the Cure-North Jersey, a breast cancer education and advocacy group based in Summit.

Another area being explored by the strike force is whether uninsured or underinsured women are finding it more difficult to get a mammogram.

"When I talk to women, a lot of them say they don't have the money," said Edward Verner, a retired Newark breast surgeon and strong advocate of women regularly examining their own breasts for irregularities.

The State Department of Health and Senior Service's program NJ CEED (Cancer Education and Early Detection) offers free mammograms to the uninsured and underinsured.

More than 13,000 women received mammograms through the program last year, compared with a little more than 7,000 in 2003.

"We educate women that a hands-on breast exam by a doctor is an essential part of their screening, along with the mammogram," said Deborah Delesantro, clinical coordinator of the CEED program based at St. Joseph's Regional Medical Center in Paterson, which also runs an outreach program.

The American Cancer Society recommends yearly mammograms starting at age 40, although women at increased risk -- such as those with a family history of breast cancer -- should talk to their doctors about whether they need to start earlier.

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