Half of U.S. women 40 and older do not get annual mammograms to screen for breast cancer, and nearly 40 percent of women 50 and older do not get the recommended biannual screenings, even though they have insurance.

The findings, presented on Thursday at the San Antonio Breast Cancer Symposium, show that many women 50 and older are not meeting the reduced breast cancer screening goals set out by the U.S. Preventive Services Task Force.

The federal advisory panel’s controversial guidelines, released late last year, recommend against routine mammograms for women in their 40s and say women in their 50s should get mammograms every other year instead of annually.

After the recommendations were released, U.S. Health and Human Services Secretary Kathleen Sebelius said the task force did not set federal policy and did not affect what services the government would pay for.

“Our study suggests that even among an insured population, many women do not meet that target, and a surprising number do not even have one mammogram in four years,” Dr. Milayna Subar who led the analysis for the Medco Research Institute, a research arm of pharmacy benefit manager Medco Health Solutions Inc, said in a statement.

The study, done between 2006 and 2009, was largely completed before the advisory group released its recommendations.

The guidelines contradicted years of messages about the need for routine breast cancer screening starting at age 40, kicking off a fury of protest among breast cancer experts and advocacy groups who argued the recommendation of fewer screenings would confuse women and result in more deaths from breast cancer.

They were meant to spare women some of the worry and expense of extra tests needed to distinguish between cancer and harmless lumps.

Many groups of experts, including the American Cancer Society, stuck by their long-standing recommendation of a yearly breast exam for women starting at age 40, stressing that the breast X-rays have been proven to save lives by spotting tumors early, when they are most easily treated.

Subar said many groups feared insurance companies would stop covering yearly mammograms for women in their 50s.

“Nobody took away the coverage, but we need to use what we have,” Subar said in a telephone interview.

She said the debate over mammograms may further discourage women from getting routine screenings.

Dr. Marisa Weiss, founder and president of Breastcancer.org, said in a statement the findings provide evidence that breast cancer advocates need to do a better job of encouraging women to have regular mammograms.

“Mammography detects 80 to 90 percent of breast cancers in asymptomatic women; so while it is not a perfect detection tool, it’s the best we currently have for saving lives and finding cancers at an early stage so that less toxic and traumatic treatments are required,” Weiss said.

Breast cancer is the second-leading cause of cancer death among U.S. women, after lung cancer. It kills 500,000 people globally every year and is diagnosed in close to 1.3 million people around the world.

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By Julie Steenhuysen

CHICAGO