Cancer Screening - Mammography

Why Is This Important?

Breast cancer is the most common cancer among women (excluding non-melanoma skin cancer) and is the second leading cause of cancer death in New Mexican women (after lung cancer). Regular mammograms are the best tests health providers have to screen for breast cancer.

Definition

Estimated percentage of New Mexican women ages 50-74 years who have had a mammogram in the past two years (i.e., current with breast cancer screening recommendations). A mammogram is an X-ray picture of the breast. Health care providers use a mammogram to look for early signs of breast cancer. The breast cancer screening questions are only administered in the BRFSS in even-numbered years. In January 2016, the United States Preventive Services Task Force (USPSTF) updated its previous 2009 recommendations for breast cancer screening; however, the update contained no changes in screening recommendations for average-risk women based on age group. For women ages 40-49 years, mammography screening is not routinely recommended, but women who place a higher value on the potential benefit than the potential harms may choose to begin screening every two years. For women ages 50-74 years, mammography screening is recommended every two years. For women ages 75 years and older, there was insufficient evidence to recommend for or against mammography screening.

Data Sources

• Behavioral Risk Factor Surveillance System Survey Data, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, together with New Mexico Department of Health, Injury and Behavioral Epidemiology Bureau.
  (https://www.nmhealth.org/about/erd/ibeb/brfss/)
• U.S. data source: Centers for Disease Control and Prevention (CDC), Behavioral Risk Factor Surveillance System (BRFSS) Prevalence and Trends Data.
  (https://www.cdc.gov/brfss/brfssprevalence)
• U.S. data source: Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion Chronic Disease Indicators, Behavioral Risk Factor Surveillance System (BRFSS) Data.
  (https://www.cdc.gov/cdi/)

How the Measure is Calculated

How Are We Doing?

The percent of New Mexican women who are current with breast cancer screening recommendations has remained stable for more than a decade.

How Do We Compare With the U.S.?

Comparable rates for the United States for "current" with breast cancer screening are only available for 2014 at this time. In 2014, among women ages 50-74 years, breast cancer screening rates were lower for New Mexico compared to the United States.

What Is Being Done?

The New Mexico Breast and Cervical Cancer Early Detection Program (BCCP) is dedicated to improving access to high-quality, age-appropriate breast cancer screening and diagnostic services for low-income women who are uninsured or under-insured, and helping them access resources for treatment when necessary. To do this, the BCCP supports changes within provider practices and health systems to increase screening opportunities. In addition, data and surveillance systems, such as monitoring screening quality measures, are used to develop more organized, systematic approaches to cancer screening and to improve service delivery. These approaches are supported by the New Mexico Department of Health and are being implemented by many healthcare organizations and health systems throughout New Mexico. Visit the BCCP website at: http://archive.cancernm.org/bcc/index.html

Evidence-based Practices

The BCCP supports New Mexico health care providers and health systems in using evidence-based interventions such as patient reminders, risk assessment tools, reducing structural barriers (e.g., expanding clinic hours, provision of mobile mammography events), provider reminder and recall systems, and provider assessment and feedback on performance. All of these activities have been shown to increase breast cancer screening rates, and are recommended by The Guide to Community Preventive Services, a collection of evidence-based findings of the Community Preventive Services Task Force, established by the U.S. Department of Health and Human Services.

Other Objectives

New Mexico Cancer Plan 2012-2017 Objectives: By 2017, increase by 15% the proportion of NM women ages 40 and older who have had a mammogram in the past 2 years, from a 2010 baseline of 71% to 81.7%. New Mexico Community Health Status Indicator (CHSI)

Available Services

The New Mexico Breast and Cervical Cancer Early Detection Program provides free breast cancer screening and diagnostic services to New Mexico women ages 40 years and older who lack health insurance and who live at or below 250% of the federal poverty level. More information can be found online at https://www.nmhealth.org/about/phd/pchb/bcc or by calling toll-free 1-833-525-1811. Uninsured women in New Mexico should check to see if they qualify for Centennial Care, which is New Mexico's Medicaid program, at: https://nmmedicaid.acs-inc.com/static/index.htm Uninsured women who don't qualify for Centennial Care may be able to purchase a health insurance plan during certain times of the year through the New Mexico Health Insurance Exchange at: http://www.bewellnm.com/

More Resources

New Mexico Department of Health Breast and Cervical Cancer Early Detection (BCC) Program (https://www.nmhealth.org/about/phd/pchb/bcc) U.S. Preventive Services Task Force, Breast Cancer Screening website (https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening1?ds=1&s=Breast Cancer Screening) Centers for Disease Control and Prevention (https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm)The Community Guide to Preventive Services (https://www.thecommunityguide.org/findings/cancer-screening-multicomponent-interventions-breast-cancer)

Health Program Information

The most effective strategy for detecting early-stage breast cancer is screening mammography. The resulting earlier treatment may be life-saving, depending on the breast cancer type and quality of care. The United States Preventive Services Task Force (USPSTF) estimates that over a ten-year period, screening 10,000 women ages 60 to 69 years would result in about 21 fewer breast cancer deaths. Over the same ten-year period, there would be about eight breast cancer deaths averted in 10,000 women screened at ages 50-59 years, and about three breast cancer deaths averted in 10,000 women screened at ages 40-49 years. Screening mammography also has risks. In addition to false-positive results and unnecessary biopsies, all women undergoing regular screening mammography are at risk for the diagnosis and treatment of noninvasive and invasive breast cancer that would otherwise not have become a threat to their health, or even apparent, during their lifetime (known as "overdiagnosis"). The USPSTF notes that the best estimates from randomized controlled trials suggest that one in five women diagnosed with breast cancer over approximately ten years will be overdiagnosed. Since we can't currently identify which breast cancers are overdiagnosed, they are all treated, meaning that one in five women diagnosed with breast cancer through screening may be enduring surgery, radiation therapy, and/or chemotherapy that she never would have needed. The BCCP is exploring the best options for providing more balanced and useable information to women about both the potential benefits and harms of breast cancer screening. The intent is to enable women to make well-informed decisions about breast cancer screening that are consistent with their values and priorities.