“Breast Cancer: A Continuing Threat”
One of the great health care success stories during the last two decades has been in the fight against breast cancer. Between 1987 and 2000, the percentage of American women age 40 or older who had mammograms in the previous two years increased dramatically, from 39 percent to more than 70 percent. The early detection these screenings provide has led to significant improvement in survival rates among those afflicted with the second most prevalent form of cancer among women in our nation.
Tragically, recent research suggests that this progress is slowing, and may even be reversing. A new report by the National Cancer Institute and the Centers for Disease Control and Prevention finds a dramatic decline in the percentage of women getting these live-saving screenings. According to this study, overall mammography rates leveled off between 2000 and 2003, and declined by 4 percent in the critical 40-and-over age group.
On May 24th, I joined my 15 female Senate colleagues at a special forum to question the authors of this study and other experts in the field to more fully explore the reasons for this decline in mammography rates and to discuss strategies to reverse this alarming trend.
It is essential that we do this. Regular screenings and early detection are currently the most effective ways to combat breast cancer and improve a woman’s chances for successful treatment and survival. Breast cancer has taken a tremendous toll on far too many Americans and their families. Virtually every person in this country has had a relative, a friend, or someone else close to them who has personally been affected by this cancer. Breast cancer will strike more than 200,000 women this year, and more than 40,000 will die from the disease, including an estimated 200 women here in Maine.
What is particularly troubling about the reports of declining mammography rates is that the odds of surviving breast cancer have increased in recent years, in part because more women have been diagnosed in the earliest, most treatable stages of the disease. Fewer women getting mammograms could translate into more women being diagnosed at later stages of the disease. This is certain to result in higher mortality rates from breast cancer.
The reasons for this decline in mammography rates remain unclear, but the researchers we met with at our forum cited several possible factors, such as increasingly long waiting times to get appointments due to a growing shortage of mammography facilities, an increase in the number of women who do not have adequate health insurance, and less certainty about the desirability of screening because of perceived inconsistent findings on the effectiveness of mammograms in preventing breast cancer deaths. I recently met with a group of Maine radiologists who speculated that the decline may also have been caused by reduced capacity because of low reimbursement by insurers, rising malpractice litigation against radiologists who read mammograms, and fewer radiologists choosing to specialize in breast imaging.
But one of the most troubling reasons cited by our panel of experts was complacency. As survival rates rise, our experts speculated that many women may feel that they do not need regular screenings. Of course, the survival rates have been rising precisely because the screening rates were so high, leading to earlier diagnosis and better outcomes. The sharp drop in hormone replacement therapy after menopause due to research published in 2002 that revealed links with breast cancer, heart attack, and stroke may also have resulted in fewer women making regular visits to their physicians for routine screening exams.
Throughout my Senate career, I have been a strong advocate for breast cancer research funding, research on possible environmental causes of breast cancer, and strong legislation to ensure that no one is discriminated against in health insurance and employment as a result of genetic information. I am especially proud to support the Centers for Disease Control and Prevention’s National Breast and Cervical Cancer Early Detection Program, which has provided important cancer screening services at low or no cost to more than 3 million low-income American women who otherwise might not have been able to afford these critically important tests. The Maine Breast and Cervical Health Program is funded through this program and provides screening and diagnostic services at 300 sites across our state. In 2005, I was honored to be recognized by the National Breast Cancer Coalition for my commitment to this issue. We have made great progress in the fight against breast cancer, with new and more effective ways to prevent, detect, and treat this devastating disease. Breast cancer continues to take a terrible toll, however, and this new research makes clear that the fight is far from over.
Throughout my Senate career, I have been a strong advocate for breast cancer research funding, research on possible environmental causes of breast cancer, and strong legislation to ensure that no one is discriminated against in health insurance and employment as a result of genetic information. I am especially proud to support the Centers for Disease Control and Prevention’s National Breast and Cervical Cancer Early Detection Program, which has provided important cancer screening services at low or no cost to more than 3 million low-income American women who otherwise might not have been able to afford these critically important tests. The Maine Breast and Cervical Health Program is funded through this program and provides screening and diagnostic services at 300 sites across our state. In 2005, I was honored to be recognized by the National Breast Cancer Coalition for my commitment to this issue. We have made great progress in the fight against breast cancer, with new and more effective ways to prevent, detect, and treat this devastating disease. Breast cancer continues to take a terrible toll, however, and this new research makes clear that the fight is far from over.
