The first drop in mammography rates since 1987 among age-eligible women occurred in 2005, and at least partial blame can be pinned on the decline in the use of hormone therapy.
A widely publicized 2002 report connecting hormone therapy with the development of breast cancer led to a dramatic decline in the number of women undergoing the treatment by 2005. Because current users of hormone therapy also tend to have higher mammography rates, Nancy Breen, PhD, of the National Cancer Institute in Rockville, Maryland, and colleagues suspected that the lower mammography rates were related to the change in hormone therapy use. They theorized that if women were no longer seeing a clinician regularly to renew their hormone prescriptions, the provider was not able to remind them as frequently to schedule a mammography.
After analyzing data from 7,125 and 7,387 women 50 years and older who participated in the 2000 and 2005 National Health Interview Surveys (NHIS), respectively, Breen’s group indeed found that women aged 50 to 64 years were more likely to report a recent mammography if they had talked with an obstetrician/gynecologist or other physician in the preceding 12 months, or if they were currently taking hormone therapy. (Other factors contributing to more recent mammography use included having a usual source of care, more education, and private health insurance; and being any race other than non-Hispanic Asian.)
Women 65 years and older were more likely to report a recent mammogram if they were younger than 75 years, talked with an obstetrician/gynecologist or other physician in the past 12 months, were currently taking hormone therapy, had a usual source of care, were in excellent health, had Medicare Part B or other supplemental Medicare insurance, had more education, and were any race other than non-Hispanic Asian.
Breen asserts that her group’s research, reported in the journal Cancer, affirmed the importance of a clinician’s recommendation in driving women to undergo mammography. “And, it shows that when circumstances change—such as evidence about [hormone therapy]—it can upset the balance and lead to unanticipated and undesirable changes in mammography use.”