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State of Alaska

Health Indicator Report of Cancer Screening - Female Breast (Mammography) - Women (Ages 50-74)

Recent data for the United States suggest why screening for female breast cancer is important. In 2010, 20% of women 50-74 years of age had not had a mammogram within the previous 2 years.^2^ Breast cancer is the most common cancer among women. In 2010, female breast cancer caused approximately 41,000 deaths.^3^ Approximately 207,000 new cases of invasive female breast cancer are diagnosed annually.^3^ For women of all ages at average risk, screening was associated with a reduction in breast cancer mortality of approximately 20%.^4^ Cancer screening rates are declining nationwide.^5^ Women with higher education and income tend to exceed Healthy People 2020 goals. Adults without insurance have the lowest screening rates. Cancer screening rates are short of the goal. In 2009, the U.S. Preventive Services Task Force changed its breast cancer screening recommendations from having a mammogram every 1-2 years for women 40 years of age and older to having a mammogram every 2 years for women 50-74 years of age.^1^ The U.S. Preventive Task Force, American Cancer Society, and American College of Radiologists all have different screening recommendations for mammography. Women aged 40-49 years should talk to their health care provider about when and how often they should have a screening mammogram. There is not yet enough evidence to understand the benefits and harms of screening mammography in women 75 years of age or older. Because disproportionately more American Indian/Alaska Native women are younger at diagnosis for breast cancer, screening beginning at age 40 is recommended.^6^ [[br]] [[br]] ---- {{class .SmallerFont 1. U.S. Preventive Services Task Force. Final recommendation statement: breast cancer: screening. [http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/breast-cancer-screening1]. Updated January 2016. Accessed April 12, 2016. 2. Centers for Disease Control and Prevention (CDC). Breast cancer screening among adult women - Behavioral Risk Factor Surveillance System, United States, 2010. MMWR 2012;61(Suppl; June 15, 2012):45-50. 3. Centers for Disease Control and Prevention (CDC). United States cancer statistics: 1999-2013 incidence and mortality data. [http://www.cdc.gov/uscs]. Accessed April 26, 2016. 4. Myers ER, Moorman P, Gierisch JM, Havrilesky LJ, et al. Benefits and harms of breast cancer screening. JAMA 2015;314(15):1615-34. 5. Sabatino SA, White MC, Thompson TD, Klabunde CN. Cancer screening test use - United States, 2013. MMWR 2015;64(17);464-8. 6. Roubidoux MA. Breast cancer and screening in American Indian and Alaska Native women. J Cancer Educ 2012;27(1 Suppl):S66-72. }}

Notes

** Data not available due to fewer than 50 respondents in the denominator.

Data Sources

  • Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion
  • U.S. Data: National Center for Chronic Disease Prevention and Health Promotion, Behavioral Risk Factor Surveillance System (BRFSS)

Data Interpretation Issues

Since 2000, the breast cancer screening questions have only been administered in the BRFSS in even-numbered years. Data are presented based upon the current U.S. Preventive Services Task Force (USPSTF) recommendation that women aged 50-74 years of age have a mammogram every 2 years.^1^[[br]] [[br]] ---- {{class .SmallerFont 1. U.S. Preventive Services Task Force. Final recommendation statement: breast cancer: screening. [http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/breast-cancer-screening1]. Updated January 2016. Accessed April 12, 2016. }}

Definition

Percentage of females 50-74 years of age who reported having a mammogram in the last two years on the [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System (BRFSS)] .

Numerator

Weighted number of females 50-74 years of age who responded "Yes" on the BRFSS to the question: "A mammogram is an x-ray of each breast to look for breast cancer. Have you ever had a mammogram?" and then either "Within the past year (anytime less than 12 months ago)" or "Within the past 2 years (1 year but less than 2 year ago)" to the question: "How long has it been since you had your last mammogram?"

Denominator

Weighted number of females 50-74 years of age who responded to the BRFSS question on ever having a mammogram and, if so, provided the timing of the last mammogram, excluding those with missing, "Don't Know/Not sure", or "Refused" responses.

Healthy People Objective: Increase the proportion of women who receive a breast cancer screening based on the most recent guidelines

U.S. Target: 81.1 percent

How Are We Doing?

In 2016, rates for screening mammograms within the past two years for those females between 50 and 74 years of age were 67.6% for all Alaska women and 68.3% for Alaska Native women. Screening rates in Alaska have declined from highs in the mid-80% range in the 2000 to 2002 period. Lower screening rates are associated with increased poverty, less education and those not married. Female breast cancer screening rates from the BRFSS are initially presented for all Alaskans, Alaska Native people, and the median from states, District of Columbia, and territories for all available years. Subsequent analyses by demographic subpopulations (i.e., age, marital status, education, employment status, income, and poverty status) are available from 1991 and later. Crosstabulations by BMI, current smoking, sexual orientation, disability, and Adverse Childhood Experiences (ACEs) score were conducted for the 3-year average of 2010-2014. Only the significant differences related to current smoking are presented, but the other comparisons are available upon request. Breast cancer screening prevalence by regions of Alaska are presented for the 5-year average time period of 2008-2016 allowing reporting for all Alaskans and Alaska Native people: 1) 7 Alaska Public Health Regions, 2) 5 Metropolitan and Micropolitan Statistics Areas and rural remainder, 3) 10 behavioral health assessment regions based upon aggregations of 20,000 population, 4) 29 boroughs and census areas, and 5) 12 tribal health organization regions. Special tables on screening rates starting at age 40, recommended for Alaska Native women, are included for all Alaskans and Alaska Native women for the period of 1991-2014 and by tribal health organization regions.

How Do We Compare With the U.S.?

Alaska screening mammogram rates have been below the U.S. median of states since 2004. Declines in screening rates have been higher in Alaska than the U.S. as a whole since 2006.

What Is Being Done?

The [http://dhss.alaska.gov/dph/wcfh/Pages/bchc/default.aspx Alaska Breast and Cervical Health Check Program (BCHC)] is dedicated to improving access to high-quality breast and cervical cancer screening and diagnostic services for women who are underserved. BCHC also works to increase public awareness through education about prevention, disease processes, and the importance of appropriate screening for early detection.

Evidence-based Practices

The Guide to Community Preventive Services is a resource to help choose programs and policies to improve health and prevent disease in communities. The [http://thecommunityguide.org/about/What-Works-Cancer-Screening-insert.pdf Community Guide for Cancer Screening] recommends client reminders, small media, group education, reducing structural barriers, and reducing client out-of-pocket costs to increase cancer screening.

Health Program Information

In collaboration with four Tribal National Breast and Cervical Cancer Early Detection Program grantees, Department of Health and Social Services' Breast and Cervical Health Check (BCHC) program is working to increase both public and provider awareness about breast and cervical cancer screening recommendations as well as access to services throughout the state. BCHC can pay for screening and diagnostic tests for low income women who are under or uninsured. For more information about eligibility of services visit the BCHC website at: [ http://dhss.alaska.gov/dph/wcfh/Pages/bchc/default.aspx].
Page Content Updated On 08/23/2017, Published on 09/21/2017
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Fri, 25 May 2018 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Thu, 21 Sep 2017 10:19:22 AKDT
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics AK-IBIS web site (http://ibis.dhss.alaska.gov/). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Fri, 25 May 2018 20:12:08 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information System for Public Health Web site: http://ibis.dhss.alaska.gov/ ".

Content updated: Thu, 21 Sep 2017 10:19:22 AKDT