Utilization of Mammogram Screening and Pap Tests | Categories Utah Women and Cancer | DOI: 10.26054/0KBWWYJD89

Background

Breast cancer is the most commonly occurring cancer in U.S. women (excluding basal and squamous cell skin cancers) and the leading cause of female cancer death in Utah. Deaths from breast cancer can be substantially reduced if the tumor is discovered at an early stage. Clinical trials have demonstrated that routine screening with mammography can reduce breast cancer deaths by 20% to 30% in women aged 50 to 69 years, and by about 17% in women aged 40 to 49 years. Recent research suggests that ultrasound may be a better screening tool for some women. Pap smears are another screening that is recommended for women.

Healthy People 2010 Objective 3.13:
Mammograms – Adults receiving within past 2 years (age adjusted, females aged 40 years and older), U.S. Target for 2010: 70%, Utah Target for 2010: 80% in 2010

Healthy People 2010 Objective 3.11b:
Pap test – Women aged 18 years and older who received a Pap test within the preceding 3 years, U.S. Target for 2010: 90%

Figure 1. Percent of Women receiving Preventive Mammograms and Pap Tests Utah, 1994-2004
Figure 1. Percent of Women receiving Preventive Mammograms and Pap Tests Utah, 1994-2004. Source: Behavioral Risk Factor Surveillance System, Center for Health Data, IBIS, Utah Department of Health

Risk Factors

The most important risk factor for breast cancer is increasing age. Other established risk factors include personal or family history of breast cancer, history of abnormal breast biopsy, early age at onset of menses, late age at onset of menopause, never having children or having a first live birth at age 30 or older. Associations have also been suggested between breast cancer and oral contraceptives, long-term use of hormone replacement therapy, obesity (in post-menopausal women), alcohol, and a diet high in fat. The American Cancer Society recommends that women aged 40 or older have an annual mammogram, while the National Cancer Institute, the U.S. Preventive Services Task Force, and the U.S. Department of Health and Human Services recommend that women 40 years or older undergo mammography every 1-2 years. Women who are at higher than average risk of breast cancer should seek expert medical advice about whether they should begin screening before age 40 and the frequency of that screening. It is recommended that women over age 21 get a Pap test and pelvic exam every 1 to 3 years.

Utah data vs. U.S.- How are we doing

Figure 2. Percent of Women Receiving Mammogram and Pap Test Utah and U.S. 2004
Figure 2. Percent of Women Receiving Mammogram and Pap Test Utah and U.S. 2004. Source: Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data.

Services/Hotlines

The Utah Cancer Control Program (UCCP) provides free to low cost clinical breast exams and mammograms to women who meet age and income guidelines. Eligible women with abnormal screening exams are offered diagnostic evaluation by participating providers. In addition, the UCCP provides education about the need for early detection and the availability of screening services, performs outreach to eligible women, uses an annual reminder system, collects outcome data and disseminates information about breast cancer. As of July 1, 2001, the UCCP is able to refer Utah women in need of treatment for breast and cervical cancers and precancerous lesions for full Medicaid benefits. The women must meet all requirements as outlined in the National Breast and Cervical Cancer Treatment Act.

References

  1. Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, custom query accessed 1/9/07
  2. Behavioral Risk Factor Surveillance System, Retrieved on 1/9/07 from Utah Department of Health, Center for Health Data, Indicator-Based Information System for Public Health. Website: http://ibis.health.utah.gov/