Why Women Don't Get Mammograms

 Sidestepping screening: What factors make women avoid annual mammography?

Breast cancer has the highest incidence and mortality rates worldwide, and it is the second leading cause of cancer deaths for women in the United States. While mammography is far from perfect, it remains the best screening tool available for the early diagnosis of breast cancer.

But studies show that about one in four women, forty and older, have not had a mammogram within the last two years. That figure is even worse for low-income women, with 40% admitting that they have never stepped within a few feet of the bucky. A recent study out of New Hampshire revealed that more than one-third of the women in that state who are eligible for mammography have either never had the breast cancer screening test or have not been tested in more than two years (Cancer, September 12, 2005).

This is despite the enthusiastic efforts by breast cancer screening advocacy groups to promote screening and boost awareness (American Cancer Society, May 9, 2005).

Of course, the issue is too complicated to attempt to summarize in a single shot. Still, breast imaging experts agree that certain broader obstacles continue to plague cancer screening programs and continue to keep women out of screening facilities.

Personal experience

Chances are that every woman knows at least one person in her life who has been diagnosed with breast cancer, treated for breast cancer, or, worst of all, had a breast cancer scare. And if it happened to a friend (or even a friend of a friend), why couldn't the same fate befall her? As a result, many women subscribe to the "ignorance is bliss" school of thought. Getting an annual mammogram would then be akin to actively searching for a problem, pointed out Dr. Daniel Kopans, director of breast imaging at Massachusetts General Hospital in Boston. The possibility of breast cancer is scary enough; the process of getting a mammogram only adds to that anxiety, he said.

For a woman who has undergone screening, one bad experience -- in the form of a false-positive mammogram or a benign biopsy -- can make for a lifetime of aversion, according to Dr. Carol Kornmehl a radiation oncologist in Ridgewood, NJ, and the author of The Best News About Radiation Therapy


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