The Morbidity and Mortality Weekly Report is prepared by the Centers for Disease Control, Atlanta, Georgia, and available on a paid subscription basis from the Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402, (202) 783-3238. The data in this report are provisional, based on weekly reports to CDC by state health departments. The reporting week concludes at close of business on Friday; compiled data on a national basis are officially released to the public on the succeeding Friday. The editor welcomes accounts of interesting cases, outbreaks, environmental hazards, or other public health problems of current interest to health officials. Such reports and any other matters pertaining to editorial or other textual considerations should be addressed to: Editor, Morbidity and Mortality Weekly Report, Centers for Disease Control, Atlanta, Georgia 30333. JUN 27 1988 e of Mammography for Breast Cancer Screening Enter d's age-adjusted mortality rates fo raN TEB STATES OF AMERICAonsis TMENT OF HEALTH AND HUMAN SERVICES/PUBLIC HEALTH SERVICE The Morbidity and Mortality Weekly Report is prepared by the Cente Georgia, and available on a paid subscription basis from the Superintendent Printing Office, Washington, D.C. 20402, (202) 783-3238. The data in this report are provisional, based on weekly reports to CDC b reporting week concludes at close of business on Friday; compiled data c released to the public on the succeeding Friday. The editor welcomes outbreaks, environmental hazards, or other public health problems of current reports and any other matters pertaining to editorial or other textual conside Editor, Morbidity and Mortality Weekly Report, Centers for Disease Control Director, Centers for Disease Control JUN 27 1988 Use of Mammography for Breast Cancer Screening Center Rhode Island, 1987 ULI WED BY Rhode Island's age-adjusted mortality ratUNTE BRSTATES OF AMERICAconsistently higher than national rates since at least 1950 (1). During this period, while age-adjusted mortality rates have remained relatively stable, demographic changes due to an aging population have led to increasing numbers of deaths from breast cancer. In 1986, the number of Rhode Island women who died from this cause was 232-more than the number who died from any other type of cancer. The Rhode Island Department of Health's Breast Cancer Screening Program is designed to reduce breast cancer mortality by promoting annual breast cancer screening, including mammography, for women ≥40 years of age. Components of the program include a broad promotional effort, a strong quality assurance program, lowered costs for mammography, and a scheduling and notification system located in the Department of Health. Women with positive, suspicious, or inconclusive findings are followed up by personal contact from health department staff, and their mammograms are also reviewed by a panel of radiologists. If widely instituted, this intervention has the potential for substantially reducing breast cancer mortality (2,3). A survey of Rhode Island women aged ≥40 was conducted to establish a baseline for evaluating the program. Women were interviewed concerning their knowledge, attitudes, and practices related to breast cancer screening, including mammography. For this survey, random-digit dialing was used to select a sample of Rhode Island households with telephones. Households that could be contacted were screened for the presence of women aged ≥40. If more than one possible respondent was identified in a household, one respondent was selected by using a procedure that randomized the selection. Because only 6% of households contacted had more than one eligible respondent, no adjustment has been made in the analysis for the lower probability of selecting women living in households with other eligible respondents. There were 852 completed interviews, for a response rate of 78%. Thirty-seven percent of women aged ≥40 reported having had a mammogram within the past year, and 70% reported having had a physical breast examination (Table 1). The likelihood of having had a mammogram or a physical breast examination in the past year was found to vary with the woman's age, education, and income. The age group U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES/PUBLIC HEALTH SERVICE Cancer Screening - Continued with the lowest proportion (29%) of women who had had a mammogram in the past year was the age group ≥70. However, 69% of this age group had had a physical breast examination, a proportion similar to that of other age groups. Among all women aged ≥40, both the proportion of women having had a mammogram and the proportion of women having had a physical breast examination increased with education and income. Nearly half of the women in the highest income group and 44% of college graduates had had a mammogram in the previous year, and 78% of both groups had had a physical breast examination. The lowest utilization rates for both procedures occurred among the poor. Since 92% of all women had seen a physician in the previous year, the observed variations in screening practices with age, education, and income do not appear to stem from differing frequencies of contact with the medical-care system (Table 1). The proportion of women who had had both a physical breast examination and a mammogram in the past year was 35%, just below the proportion who had had a mammogram. When respondents were grouped by age, education, and income, the proportion having had both screening procedures follows closely the total proportion having had a mammogram. Of the women who reportedly had a mammogram in the past year, 96% also had had a physical breast examination. Of those who had not had a mammogram, 54% had had a physical breast examination in the past year. Women who had not had a mammogram in the past 3 years were asked-in an open-ended question-for the reason. Many (32%) responded that they did not TABLE 1. Percentage of women ≥40 years of age who, in the past year, saw a physician, had a physical breast examination (PE), had a mammogram, and had both PE and a mammogram, by age group, years of schooling, and income - Rhode Island, 1987 'Income levels are expressed in relation to poverty income. Poverty income varies with family size and is based on annual guidelines established by the Department of Health and Human Services for the period July 1, 1987-July 30, 1988 (4). |