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Numerator

Sample women respondents age 50+ who report having mammogram in past 2 years

Denominator

Sample women respondents age 50+ with valid response for mammography question

Methodology

Based on the BRFSS questions: "A mammogram is an x-ray of each breast to look for breast cancer. Have you ever had a mammogram?" and "How long has it been since you had your last mammogram?"

 In 2011, two methodological refinements were made to the Behavioral Risk Factor Surveillance System (BRFSS). The first was to expand the sample to include data received from cell phone users. This change was made to reflect the population better. The second change was to modify the statistical method to weight BRFSS survey data. The new approach simultaneously adjusts survey respondent data to known proportions of demographics such as age, race and ethnicity, and gender. Prior to 2011, the weighting method was post stratification, while in 2011 it is raking. Raking is better able to account for more demographic characteristics and multiple sampling frames. Because of these changes, data collected in 2011 and later cannot be appropriately compared to previous data, although new results should better reflect the health status of the United States (see http://www.cdc.gov/surveillancepractice/reports/brfss/brfss.html).

In order to create multi-year estimates, two changes were made to the new data. First, respondents who only have cell phones were removed. Second, weights were created specifically for this purpose using the post stratification method. Those two changes make the 2011 data similar to the pre-2011 data and allowed multi-year estimates to be created, even though these estimates will not be as representative of the U.S. population as the single-year estimates using 2011 data without these changes.

Efforts to create a new small area estimate methodology that will allow use all of the improvements instigated with the 2011 data are currently taking place. Once available, that methodology will be used for estimates provided here.

For Years 2002, 2006, 2008: data available for all states. For Year 2001: data only available for: Arizona, Arkansas, Colorado, Georgia, Hawaii, Mississippi, New Jersey, Oklahoma, Rhode Island, South Dakota, Tennessee, Wisconsin, Wyoming. For Year 2003: data only available for: Arkansas, Georgia, Hawaii, Iowa, Mississippi, Missouri, New Jersey, Oklahoma, South Dakota, Tennessee, Vermont, Wyoming. For Year 2004: data available for all states except Hawaii. For Year 2005: data only available for: Arkansas, Georgia, Iowa, Maine, Mississippi, Nevada, New Jersey, Tennessee, Vermont, Virginia, Wyoming. For Year 2007: data only available for: Arkansas, Delaware, Florida, Georgia, Hawaii, Nevada, Tennessee, Wyoming. For Year 2009: data only available for: Georgia, Hawaii, Tennessee, and Wyoming.

Estimates based on fewer than 50 cases or with a confidence interval half-width of 10% or more ((upper CI-lower CI/100) >10) are considered unreliable and are not displayed.

Caveats

The questions regarding mammography are part of a series of questions asked every other year in the BRFSS questionnaire, on the even years. States have the option to include the questions in the odd years in which they are not in the standard questionnaire. For those states in those years that opt to include the questions, the estimates represent annual averages of a greater number of years. Estimates that end on an odd year are not provided through the HIW.

References

U.S. Preventive Services Task Force. Screening for Breast Cancer: Recommendations and Rationale. February 2002. Agency for Healthcare Research and Quality, Rockville, MD. http://www.nyqa.org/pdf-lib/USPSTFBreastcancerscreening.pdf.

Interventions

Screening for Breast Cancer

The USPSTF recommends biennial screening mammography for women aged 50 to 74 years.

Cancer Prevention & Control, Client-oriented Screening Interventions: One-on-One Education

One-on-one education is provided in person or by telephone to encourage individuals to be screened for cancer.

Cancer Prevention & Control, Client-oriented Screening Interventions: Reducing Out-of-pocket Costs

Some interventions seek to increase cancer screening by reducing out-of-pocket costs.

Cancer Prevention & Control, Client-oriented Screening Interventions: Reducing Structural Barriers

Many barriers can make it difficult for people to seek screening for cancer.

Cancer Prevention & Control, Client-oriented Screening Interventions: Client Reminders

Reminders include letters, postcards, or phone calls to alert clients that it is time for their cancer screening.

Cancer Screening - Small Media

Small media include videos and printed materials such as letters, brochures, and newsletters.

Cancer Prevention & Control, Provider-Oriented Screening Interventions: Provider Assessment and Feedback and Provider Reminders and Recall

Provider-oriented interventions aim to increase recommendation and delivery of screening for cancers by health care providers.