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Mammography use and breast cancer incidence among older U.S. women

Breast Cancer Research and Treatment volume 188, pages 307–316 (2021)Cite this article

A Correction to this article was published on 05 April 2021

This article has been updated

Abstract

Purpose

The death rate for female breast cancer increases progressively with age, but organizations differ in their mammography screening recommendations for older women. To understand current patterns of screening mammography use and breast cancer diagnoses among older women, we examined recent national data on mammography screening use and breast cancer incidence and stage at diagnosis among women aged ≥ 65 years.

Methods

We examined breast cancer incidence using the 2016 United States Cancer Statistics dataset and analyzed screening mammography use among women aged ≥ 65 years using the 2018 National Health Interview Survey.

Results

Women aged 70–74 years had the highest breast cancer incidence rate (458.3 cases per 100,000 women), and women aged ≥ 85 years had the lowest rate (295.2 per 100,000 women). The proportion of cancer diagnosed at distant stage or with unknown stage increased with age. Over half of women aged 80–84 years and 26.0% of women aged ≥ 85 years reported a screening mammogram within the last 2 years. Excellent/very good/good self-reported health status (p = .010) and no dependency in activities of daily living/instrumental activities of daily living (p < .001) were associated with recent mammography screening.

Conclusion

Breast cancer incidence rates and stage at diagnosis vary by age. Many women aged ≥ 75 years receive screening mammograms. The results of this study point to areas for further investigation to promote optimal mammography screening among older women.

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Fig. 1

Data availability

All data is free and available online at the links included in the manuscript and references.

Code availability

SAS and SUDAAN code will be made available upon reasonable request.

Change history

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Acknowledgements

The authors would like to thank Jessica King and Zahava Berkowitz for statistical and programming consultation. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the National Cancer Institute.

Funding

Dr. Turbow’s work on this project and paper was supported in part by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number D33HP31669 and title “Preventive Medicine Residencies” for $1,936,878. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government.

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Authors and Affiliations

  1. Division of Preventive Medicine, Department of Family and Preventive Medicine and Division of General Internal Medicine, Department of Medicine, Emory University School of Medicine, 49 Jesse Hill Jr Dr. SE, Atlanta, GA, 30303, USA

    Sara D. Turbow

  2. Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA

    Mary C. White & Susan A. Sabatino

  3. Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Erica S. Breslau

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Contributions

ST: Conception and design, data analysis and interpretation, drafting and revising article, final approval of submitted version. MW: Conception and design, data interpretation, drafting and revising article, final approval of submitted version. EB: Conception and design, data interpretation, drafting and revising article, final approval of submitted version. SS: Conception and design, data analysis and interpretation, drafting and revising article, final approval of submitted version.

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Correspondence to Sara D. Turbow.

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Conflict of interest

Dr. Turbow has received grant support from Gilead Sciences, Inc. and Merck for research unrelated to this work. No other financial or personal conflicts exist. No other authors reported conflicts of interest.

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Turbow, S.D., White, M.C., Breslau, E.S. et al. Mammography use and breast cancer incidence among older U.S. women. Breast Cancer Res Treat 188, 307–316 (2021). https://doi.org/10.1007/s10549-021-06160-4

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Keywords

  • Older adults
  • Mammogram
  • Breast cancer
  • Incidence