Breast Cancer Screening

The percentage of women aged 50 to 74 years who reported having had a mammogram within the past 2 years, by race/ethnicity, income, and education level.

Measurement challenges

We track breast cancer screening rates in U.S. women using a large, national, in-person survey in which people are asked about their health behaviors and the medical care they receive (see Data Source, below). There are important limitations to this method that impact what information we can accurately collect and how confident we can be in the findings. Studies have found that certain types of healthcare survey questions can be difficult for people to clearly understand and answer, and it is easy for some questions to be misinterpreted.

In the case of breast cancer screening, it can be challenging to determine by self-report alone if a woman received a mammogram for the purposes of looking for asymptomatic, previously undetected cancer (i.e., for screening purposes), or to follow up on symptoms or suspicious findings from a prior test (i.e., for diagnostic purposes). From an individual’s point of view both tests appear similar to the patient experiencing them. Additionally, looking for new or recurrent asymptomatic cancer in a person previously diagnosed and treated for that cancer type represents a third type of testing known as surveillance testing. People may also not always accurately recall the specific time they received a particular test. Our measure captures general receipt of a mammogram (yes/no) more accurately than its underlying purpose, and the population may include those with a prior diagnosis of breast cancer. This serves as a reasonable approximation, although an overestimate, of the true U.S. breast cancer screening rate, i.e., the measure is not perfectly comparing the actual frequency of women’s use of mammograms to national recommendations.