Home/Health/Articles/Mammograms are recommended beginning at age 50. Are women getting them?
Adjusting for age, 71.6% of women 50 and older have had a mammogram screening in the past two years. This figure includes women of all backgrounds, including education, race, income level, and other factors, including insurance status — which denotes the biggest gap between who does or doesn’t get screened.
According to the Centers for Disease Control and Prevention (CDC), breast cancer is the most commonly diagnosed cancer in women, with approximately 119 per 100,000 women in the United States diagnosed with a new case in 2020. Among women’s cancer deaths, it is the second most common cause, responsible for approximately 19 deaths per 100,000 women in 2020.
While the annual number of new breast cancer cases increased since 1999, the annual age-adjusted rate of breast cancer has decreased 2.4% from 1999 to 2019.
The breast cancer mortality rate has decreased at a faster rate, dropping 28% from 1999 to 2020. In other words, while the diagnosis rate hasn’t changed much in the last two decades, the survival rate has improved.
The CDC’s Preventive Services Task Force recommends mammography screenings every other year for women 50 to 74 years old who have average breast cancer risk. It also recommends that women ages 40 to 49 talk to their doctors about establishing a screening routine.
Based on the CDC’s recommendations, the Department of Health and Human Services (HHS) set a goal of getting 80.3% of women ages 50 to 74 to have a mammogram within the last two years by 2030. Although this target does not apply to all ages of eligible women, it is a benchmark to understand the rate at which women get mammogram screenings.
Analyzing the data on women 40 and older by insurance status, age, race, education level, and poverty level, reveals disparities in who gets screened. In this data, the screening rate is the age-adjusted percentage of women who have had a mammogram in the past two years.
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The biggest gap in regular mammogram screenings is between insured and uninsured women
When comparing mammogram screenings rates across a range of factors, the biggest gap is between people with and without health insurance.
In 2019, there was a 33-percentage point difference in the screening rate between women who had health insurance and those who did not (73% compared to 41%). This was up from a 30-percentage point difference in 1993.
Women below the poverty level were 18 percentage points less likely to get screened than women well above it
Poverty signals the third-largest gap between women who screen most and least.
Women below 100% of the poverty level are least likely to have a mammogram: 59% of women in this group had one in the last two years as of 2019. Women at the highest multiple percentage, 400%+ over the poverty line and higher, were most likely, 77%, to have a mammogram in the last two years.
The gap regarding poverty and mammogram screenings isn’t as big as it used be. The difference between the highest and lowest income levels in 2019 was 18 percentage points, down from 28 percentage points in 1987.
There was a 13 percentage point difference in the mammogram screening rates among women who have had some college or more versus women who do not have a high school diploma or a GED equivalent.
In 2019, 60% of women without a high school diploma reported having a mammogram in the previous two years, versus 73% of women with some college or more education. The gap has narrowed from 20 percentage points when data was first collected in 1987.
The survey and methodology to gather this screening data was updated in 2019. Unless otherwise specified, rates are reported as age-adjusted rates. The CDC projects current diagnosis or death rates to the 2000 US standard population. Age-adjusted data allows for comparisons of health data over time or between groups more fairly by accounting for the age differences in different populations. This measurement makes health statistic comparisons more accurate than just using crude rates.
Comparisons of 2019 data to previous years may not be exact comparisons and should be made with caution.
Frequently asked questions about mammogram screenings
What is a mammogram screening?
A mammogram screening is an exam that involves low-dose X-ray images of the breast to identify abnormal growths or changes such as tumors or microcalcifications. These images, called mammograms, help detect breast cancer at its earliest stages, often before symptoms manifest.
Mammogram screenings are offered through a referral from a primary care physician, community health centers, or mobile mammography units.
What is the Mammography Quality and Standards Act of 1992?
This law requires that all facilities be properly equipped to perform mammograms and adhere to required standards. All mammography clinics are certified by the FDA according to the Mammography Quality and Standards Act of 1992.
The MQSA was most recently updated in March 2023 which addresses updates in mammogram technology, as well as evaluating and reporting breast density in screening reports, which is a factor in screening difficulty.
Are mammograms available in all states?
Yes, mammography clinics are available in all states and in Washington, DC.