In the United States, breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer-related deaths among women. According to the American Cancer Society, in this year alone, an estimated 226,900 new cases of female breast cancer will be diagnosed and 39,500 women’s lives are expected to be claimed by this disease [1].

To commemorate October as National Breast Cancer Awareness Month, data from PHMC’s Community Health Data Base’s (CHDB) 2010 Southeastern Pennsylvania Household Health Survey were analyzed for women 40 years of age or older who never received a mammogram screening for breast cancer. The Southeastern Pennsylvania Household Health Survey collects information, including cancer screenings among other topics, from a random landline and wireless telephone survey conducted with 10,000 households in the five-county Southeastern Pennsylvania (SEPA) region of Bucks, Chester, Delaware, Montgomery, and Philadelphia.

In Southeastern Pennsylvania (SEPA), 6.4% of women 40 years of age or older never received a mammogram screening for breast cancer. This percentage represents more than 68,000 women in our region. Across the SEPA region, the percentage of women who never received a mammogram screening is as follows: 7.5% for Philadelphia County, 6.4% for Delaware County, 6.3% for Bucks County, 5.3% for Montgomery County, and 4.9% for Chester County. The additional findings presented in this article, below, highlight socio-economic differences for women who never received a mammogram screening and that women who never received this screening are also more likely to be disconnected from the healthcare system.

Demographic and Socio-economic Characteristics

Women ages 40-49 years (12.9%) are more likely to have never received a mammogram screening than women ages 50-59 years (3.4%), women ages 60-74 years (3.7%), and women ages 75+ years (7.0%).

In general, as the level of educational attainment increases, the percentage of women who never received a mammogram screening decreases: 8.1% of women with less than a high school diploma; 7.1% of women with a high school diploma; 7.4% of women with some college education; 5.6% of women with a college degree; and 3.6% of women with a post-graduate degree never received a mammogram (Figure 1).

Women living below 150% of the Federal Poverty Level (11.0%) are more than twice as likely as women living at or above that same poverty level (5.2%) to have never received a mammogram screening [2].

Approximately one in 13 Black women (7.8%) and one in 14 Latina women (7.1%) never received a mammogram screening, compared with 5.7% of white women.

Women who are living alone (6.9%) are similarly as likely as women who are not living alone (6.2%) to have never received a mammogram.

Access to Care Characteristics

In Southeastern Pennsylvania, women without a regular source of health care (14.7%) are more than twice as likely as women with a regular source of health care (5.9%) to have never received a mammogram screening (Figure 2).

Among women 40-64 years of age, those who are uninsured (18.3%) are more than three times as likely as those who are insured (5.7%) to have never received a mammogram screening.

There is also evidence to suggest that women who have never had other types of cancer screenings are more likely to have also never had a mammogram screening.

• More than one-half of women who have never received a pap test for cervical cancer have also never received a mammogram screening (52.7%). In comparison, 5.1% of women who have ever had a pap test for cervical cancer have never received a mammogram screening for breast cancer.
• More than eight in 10 women who have never had a clinical breast exam (82.2%) have also never received a mammogram screening, while 4.2% of women who have ever had a clinical breast exam have never had a mammogram screening.

For more information about these findings, please contact Nicole Dreisbach at nicoled@phmc.org.

To download a PDF version of this article, please click here.

Last year at this time, CHDB data from the 2010 Southeastern Pennsylvania Household Health Survey were analyzed to identify disparities among women 40 years of age or older who did not receive a mammogram screening within the past year. To read more about those findings, please click here.