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Cancer Trends Progress Report – 2009/2010 Update

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In the Report
Introduction
Trends-at-a-Glance
Summary Tables
Prevention
Early Detection
> Breast Cancer Screening
Cervical Cancer Screening
Colorectal Cancer Screening
Diagnosis
Treatment
Life After Cancer
End of Life



Breast Cancer Screening
Early Detection

Mammography use rose steadily in women aged 40 and older until 2000, was stable until 2003, and dropped slightly in 2005. The 2010 target for all women, 70 percent, was met in 2000 but the proportion fell to 67 percent in 2005. Rates fell for non-Hispanic White, non-Hispanic Black, and Hispanic women. Disparities remain for immigrants and those with lower incomes, with less education, without insurance, and lacking a usual health care provider.

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Benefits of Screening Mammography

Regular use of screening mammograms, followed by timely treatment when breast cancer is diagnosed, can help reduce the chances of dying from breast cancer. For women between the ages of 50 and 69, there is strong evidence that screening lowers this risk by 30 percent. For women in their 40s, the risk can be reduced by about 17 percent. For women aged 70 and older, mammography may be helpful, although firm evidence is lacking.

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Measure

Percentage of women aged 40 and older, by racial/ethnic, geographic, and low-income groups, who reported having had a mammogram within the past 2 years.

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Period – 1987–2005

Note: The most recent (2008) data are currently being reviewed. This section will be updated once research results have been published.

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Trends – Rising until 2000, then stable for Whites while continuing to rise for other racial/ethnic groups until 2003. Among White women aged 40 and older, trend fell slightly from 2003 to 2005.

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Most Recent Estimates

In 2005, 67 percent of women aged 40 and older had a mammogram within the past 2 years, a statistically significant drop from 70 percent in 2003. Among racial/ethnic groups, 59 percent of Hispanics (down from 65 percent in 2003), 65 percent of Blacks (down from 70 percent in 2003), and 68 percent of Whites (down from 71 percent in 2003) had a mammogram within the past 2 years, but these drops were not statistically significant. Among Asian women interviewed in California only, 74 percent had a mammogram in 2005, the same rate as in 2003.

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Healthy People 2010 Targets

Increase to 70 percent the proportion of women aged 40 and older who have had a mammogram within the past 2 years. This target was met in 2003, but the rate dropped to 67 percent, below the target, in 2005.

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Groups at High Risk for Not Being Screened

Women who are immigrants and those with lower incomes, with less education, without insurance, and lacking a usual health care provider are less likely to get screening mammograms.

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Key Issues

Cost and knowledge barriers, including lack of insurance and lack of provider recommendations for regular mammograms, need to be removed.

While millions of women have had at least one screening mammogram, many women still have not. Also, even among those women who have had a recent screening mammogram, many do not have them on a regular basis. For women to benefit from mammography, regular screening is needed.

In November 2009, the USPSTF modified their recommendations for mammography screening for specific age groups. For women aged 50 to 74 years, biennial screening mammography was recommended the previous recommendation was for women aged 40 to 69. Evidence for the decision to start regular, biennial screening mammography before the age of 50 years showed more harms and smaller benefits for this age group than for older women and therefore it was recommended that this should be a decision for individual patients and their physicians to make. For women 75 years or older, the USPSTF concluded that the current evidence is insufficient to make a recommendation.

Different organizations have generated different guidelines. To see guidelines issued by the U.S. Preventive Services Task Force and others, go to http://www.ahrq.gov/clinic/USpstfix.htm. The Guide to Community Preventive Services, http://www.thecommunityguide.org/index.html External link, is a source of information about evidence-based approaches for enhancing cancer screening.

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Additional Information on Breast Cancer Screening

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Back: Early Detection

National Cancer InstituteDepartment of Health and Human ServicesNational Institutes of HealthUSA.gov