Only one in 20 follows schedule recommendations, researchers say.
Mammograms are quick, relatively painless and potentially lifesaving tests.

Yet despite countless public service campaigns extolling the benefits of the breast cancer screening tool, only a small minority of women follow exactly the recommended guidelines for getting the exams, recent studies show.

Experts caution that women can’t depend on their doctor or their health plan to remind them when the test is due. So they must develop their own strategies to adhere more closely to the recommended guidelines.

Annual Mammogram are recommended for women age 40 and older. But only one in 20 women consistently follows that recommendation, according to a study published last year in the online edition of Cancer, a journal of the American Cancer Society.

Harvard Medical School researchers reviewed data from more than 72,000 women who got screening Mammogram from 1985 to 2002 at Massachusetts General Hospital’s Avon Comprehensive Breast Center. They found that only 6 percent of the women who had a mammogram in 1992 got all the annual screenings available to them over the next decade. Over the 10-year period, most women got five mammograms, half the number recommended by the American Cancer Society.

When the researchers looked at subgroups, they found that women from lower income levels got fewer mammograms than did wealthier women. And Hispanic, black and Asian women got fewer mammograms than other women.

Breast cancer is the most common cancer among women, other than skin cancer, and is the second leading cause of cancer death in women, after lung cancer. About 211,240 women in the United States will be diagnosed with invasive breast cancer in 2005, and an estimated 40,400 women will die from the disease this year, according to the American Cancer Society.

If breast cancer is detected when it is still localized and hasn’t spread to the lymph nodes, the five-year survival rate is 97 percent, according to the cancer society. And mammograms are designed to detect cancers early.

But some breast health experts say women may not be doing as poorly as the Harvard study indicates.

Debbie Saslow, director of breast and gynecologic cancer for the American Cancer Society, said that while women may not get a mammogram at exactly the same time each year, many are getting the screenings within a few months of each annual date.

“For all women age 40 and over, 55 percent got a mammogram in the past year and 70 percent got one in the past two years,” Saslow said, citing statistics from the National Center for Health Statistics.

Dr. Susan Love, another breast cancer expert and president of the Dr. Susan Love Research Foundation in Pacific Palisades, Calif., agreed. “I don’t think we are flunking,” she said.

While women have room for improvement in adhering to mammography guidelines, Love said she’d give most women a “C plus” or a “B” grade for trying.

With job and family responsibilities, it’s sometimes difficult to get a mammogram on a yearly basis, she added. Love, who is 57, said her last mammogram interval was almost 18 months.

Love encourages women to find a reminder or a trigger that will get them back to the doctor as close to the one-year mark as possible. “I usually try to schedule it around my kid’s birthday,” she said.

“Even if you don’t get it done on that exact date,” she added,” you can at least schedule it.”

Saslow and Love both agreed that health-care providers need to devise better reminder systems. “The No. 1 thing that would help is, if the doctors would tell women to get a mammogram,” Saslow said. “But very few health systems or individual offices have reminders for cancer screening.”

Both women noted that such reminder systems are routine for dentists’ offices, and even veterinarians, who often send postcards that your pet needs a distemper shot or other immunization.

Saslow said the American Cancer Society has some pilot projects under way to create such reminder programs. “If you ask the individual who did not get a mammogram why, the No. 1 reason you will hear is, ‘My doctor did not tell me to,’ ” she said.

Until those systems become standard practice, women must remind themselves to get a yearly mammogram.

“Some plans allow you to make the appointment a year in advance,” Saslow said, so women can schedule their next visit while having their current exam.

Several Web sites, including the American Cancer Society’s, offer reminders by e-mail, she said.