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Decline in Hormone Therapy Linked to Fewer Mammograms
Date:8/22/2011

By Kathleen Doheny
HealthDay Reporter

MONDAY, Aug. 22 (HealthDay News) -- The dramatic decline in women's use of hormone therapy mid-decade also appears linked to a decline in mammograms, new research suggests.

"We found that women in the age group 50 to 64 reduced their hormone therapy use from 41 percent down to 16 percent between 2000 and 2005," said study lead author Nancy Breen, an economist with the U.S. National Cancer Institute. "At the same time, that age group dropped their mammogram use from 78 percent to 73 percent."

"And we found those two drops were associated," she added.

Breen speculates that women are not going for mammograms as often because they aren't returning to their doctors for hormone therapy prescriptions.

The study was published online Monday in the journal Cancer.

The use of hormone therapy dropped radically after a report from the Women's Health Initiative, published in 2002, showed hormone therapy use was linked to an increased risk of breast cancer.

In 2005, mammography rates took a first-ever decline according to U.S. data.

So Breen and her colleagues set out to see whether there might be a link. Using the National Health Interview Survey, the largest population-based national sample on mammography use, they looked at data on 7,125 women interviewed in 2000 and 7,387 women interviewed in 2005. All were 50 years of age or older.

They found that those between the ages of 50 and 64 were more likely to report a recent mammogram if they were still taking hormone therapy or had seen their doctor in the past 12 months. Levels of insurance and education were other variables that played a part.

The researchers noted, however, that the decline in hormone therapy did not explain the mammography decline for women 65 and older.

If the authors' speculation is correct -- that women are forgoing mammograms because they are not seeing their doctor about hormone use -- ''health care providers should find other ways to contact these women to encourage screening," said Dr. Daniel B. Kopans, a member of the Breast Imaging Commission for the American College of Radiology.

Kopans, a radiology professor at Harvard Medical School and senior radiologist at Massachusetts General Hospital, added, "Mammography screening is not perfect. It does not find all cancers and does not find all cancers early enough to result in a cure. But the death rate from breast cancer, unchanged for 50 years prior to the onset of screening, has now decreased by over 30 percent, primarily due to screening."

Some health-care plans have reminder systems in place, letting women know when it's time for their mammogram. The American College of Radiology offers consumers a reminder system, as well.

Women could come up with their own ways to remember, Kopans said. "My sister and her girlfriend go every year at the same time, and we all go to dinner afterwards," he added.

More information

A free mammogram reminder is available through the American College of Radiology.

SOURCES: Nancy Breen, Ph.D., economist, National Cancer Institute, Rockville, Md.; Daniel B. Kopans, M.D., professor of radiology, Harvard Medical School, director, breast imaging division, department of radiology, Massachusetts General Hospital Avon Breast Evaluation Center, Boston; Aug. 22, 2011, Cancer, online


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