Decline in Hormone Therapy Use Linked to Drop in Mammography Rates

The dramatic drop in hormone therapy use over the last decade, following research that revealed the treatment’s association to breast cancer, has also paved the way for a sharp decline in mammography rates. According to a new study

, the decrease in the number of mammograms among older women may be the result of fewer doctor visits.

According to lead study author Nancy Breen, an economist with the U.S. National Cancer Institute, the study found that hormone therapy use plummeted from 41 percent to 16 percent between 2000 and 2005 among women ranging in age from 50 to 64, findings also revealed that the same age group dropped their mammogram use from 78 percent to 73 percent. “We found those two drops were associated,” she said.

Breen speculated that the decline in mammography may be due to women having no further need for obtaining hormone therapy medication prescriptions, which equates to fewer doctor visits.

Following a 2002 report from the Women’s Health Initiative showing a link between hormone therapy use and an increased risk of breast cancer, use of hormone therapy dropped drastically. Then in 2005, U.S. data showed a first-time decline in mammography rates.

The duel decline prompted Breen and her colleagues to research the possibility of a link. With the use of the biggest population-based national sample of mammography use known as the National Health Interview Survey, the research team analyzed data on a total of 14,512 women who were 50 years of age or older. Among the women, 7,125 were interviewed in 2000 and 7,387 were interviewed in 2005.

Findings revealed that among women aged 50 to 64 were, recent mammograms were reported most often by those still using hormone therapy, or those having visited their doctor within the past year. Other factors affecting mammography use included education and amount of health insurance.

Curiously, the decline in hormone therapy was not found to be linked to the decrease in mammography use among women ages 65 and older. Although fewer than 10 percent of the older women continued to use hormone therapy in 2005, a drop of about 20 percent from five years earlier, no significant drop in mammogram rates were found by the research.

Regarding the study results, Breen said, “Our research corroborates that a doctor's recommendation is an important step in getting a mammogram and it shows that when circumstances change—such as evidence about HRT—it can upset the balance and lead to unanticipated and undesirable changes in mammography use.” She noted that in this case, there are fewer reminders to schedule breast exams.

The researchers are concerned that the alarming decrease in mammogram rates could lead to a higher number of tumors, as well as more-advanced tumors being diagnosed later. Breen pointed out that missed mammograms could also account for a small portion of the initial decline recently seen in breast cancer rates.

About 1 in 8 women in the United States (12 percent) will develop invasive breast cancer over the course of her lifetime. In 2010, an estimated 207,090 new cases of invasive breast cancer were estimated to be diagnosed among women in the U.S., along with 54,010 new cases of non-invasive (in situ) breast cancer. Although less than 1 percent of new breast cancer cases occur among men, about 1,970 new cases of invasive breast cancer were estimated to be diagnosed in men in 2010.
Having routine mammograms, in combination with clinical breast exams performed by your doctor, is the most effective way to detect breast cancer early. Finding breast cancer early greatly improves the chances for successful treatment.