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Rhode Island Women Lead the Nation in Mammograms, Survey Says

Posted on: Wednesday, 6 July 2005, 18:00 CDT

Jul. 5--A survey by the U.S. Centers for Disease Control and Prevention found that last year, 82.4 percent of Rhode Island women age 40 and older had obtained a mammogram within the previous two years, tying with Delaware for first place.

Rhode Island was alone in first place in 2002, with 85.4 percent of women saying they'd gotten mammograms within the previous two years. The national average was 76 percent.

The American Cancer Society recommends that every woman age 40 and older get a mammogram once a year. Although not foolproof, mammography has the potential to detect tumors when they are smaller and easier to treat.

Research by Dr. Maureen A. Chung, a surgical oncologist at Rhode Island Hospital, and colleagues points to the importance of mammography. In one study, published last year, they found that nearly two-thirds of Rhode Island women who died of breast cancer had either never had a mammogram or had not had one in the three years before diagnosis.

Another study that Chung worked on documented a 25 percent decrease in Rhode Island breast-cancer deaths from 1987 through 2001. Chung believes some of the decrease can be attributed to higher mammography rates, and some to better treatments.

This study also showed that in Rhode Island, stage 3 and stage 4 breast cancers -- the more advanced, deadlier tumors -- have also declined, while national data does not yet show a similar decline. Chung credits the state's high mammography rates.

"Early detection, coupled with treatment, saves lives," said Dr. Sharon Marable, medical director of the state Office of Women's Health. Marable said that some women have feared getting mammograms because they thought a cancer diagnosis was a death sentence, but the latest information "lets us know we're getting over that barrier."

What's the secret of Rhode Island's success?

Dr. Barbara Schepps, director of the Anne C. Pappas Center for Breast Imaging at Rhode Island Hospital, said the presence of Brown Medical School and a hospital for women -- Women & Infants -- has led to better-educated providers and patients, who have responded to a statewide push to get women in for the tests.

Also, Schepps said, the Health Department "has been wonderful about taking care of the underinsured as well as the uninsured." The state's Women's Cancer Screening Program provides mammograms to women who should get them but don't have coverage for them. Then, if a problem is detected, grant money pays for the treatment.

Additionally, says Dr. Pat Spencer, chief of radiology at Women & Infants Hospital, women in this state rarely have to travel more than 20 or 25 miles to get care. "People have all the advantages of urban health care very close to their home," she said.

The downside, however, is that waits for mammograms in Rhode Island can be long -- from weeks to months or even a year to get a screening mammogram. "Mammography is not a high-revenue procedure," Spencer said. "Hospitals are doing this out of a mission to women in this state, basically."

Some radiology practices prefer to stay away from mammography because payment from insurers is very low -- and the liability is high. Reading a mammogram is difficult work, and if a woman later is diagnosed with cancer, a radiologist might be sued for failing to detect it in the mammogram.

For more information about the state's Women's Cancer Screening Program, go to www.health.ri.gov/disease/cancer/women-screening.php or call (401) 222-4324.

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Copyright (c) 2005, The Providence Journal, R.I.

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Source: Providence Journal

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