October is Breast Cancer Awareness Month and reminds us of the importance of doing a self-examination or having a breast screen. Breast cancer is the second most common cancer in women. Many of us know someone who has been diagnosed with breast cancer and many of those women have made a full recovery because the cancer was detected early. When you see your beautiful friend in Breast screen communications, it really prompts you to act. Early detection of breast cancer saves lives. Despite the availability and accessibility of breast screening services, many women avoid participation. There are a range of reasons (fear it’s painful or time consuming) that influence engagement and uptake of these breast screening services.
Regular breast screening is the most effective way to reduce deaths from breast cancer.
The Australian Government has offered free breast screening services (mammograms) to all Australian women within the appropriate demographics, and yet usage of these is limited, with these services failing to meet the national targets. The national breast screening program has a target of 70 percent of eligible women; however, according to the AIHW the current rate is lower than the desired participation rate at 54 percent.
In Australia, women can have a free mammogram from the age of 40. However, medical practitioners find it difficult to convince some women to take part in screening tests and encouraging women to have a mammogram seems to be particularly difficult at times. This is a concern since close to 1 in 7 women will be diagnosed with breast cancer by age 85 and early detection can save their lives.
So why do some women avoid a breast cancer screening if it is free and easy to do?
Our research found there are many reasons that women don’t have mammograms. Women weigh up the pros and cons of having a mammogram before deciding to have one. The trade-offs among these potential consequences of screening vary in magnitude and importance depending on women’s age, health and personal values. Although not an issue in many countries where medical testing is covered under universal health insurance plans, in some countries, women have to pay to have a mammogram and the cost is a barrier. Some women are concerned about the radiation from the mammogram, however, the dosage is small, and technology continues to improve to ensure that mammograms are as safe as possible. Time constraints are often a consideration. In this case, Australian women can be assured that mammograms don’t take up a lot of your time and there is a range of convenient locations often close to home or work.
Often women mention a fear that the mammogram will hurt. Again, with advances in technology, the procedure itself has improved. A mammogram can be a bit uncomfortable, but it’s quick and well worth the time if the result is early detection of cancer or peace of mind. Abnormalities in mammograms aren’t always cancer either. Other issues are things such as cysts. If there is a cancer diagnosis, the earlier a tumour is found, the better the outcomes.
Knowing that early detection of breast cancer can save lives, health care providers strive to find ways to help women to understand their risk and encourage them to have mammograms. According to our research women place a great deal of trust in their medical practitioner. They undertake mammograms for peace of mind but also to ensure they remain healthy for their family and loved ones. A recently published commentary of an article describes the outcomes of a systematic review of ‘the effectiveness of patient decision aids in the decision to have a mammogram’. Although the review included women in their 30’s (who are not in the ages routinely screened in some countries), the results were discouraging in that patient decision aids did not increase the number of women intending to have mammograms.
Technology will keep improving and future mammograms will take up even less time and will become less uncomfortable. The best way to increase uptake of mammograms is the frank discussion between a woman and her general practice caregiver. If you are over 40, you are encouraged to book in for a mammogram, it is quick, and it is free, and will give you peace of mind and allow you to be there for your family and loved ones.
Take the time this month to find out what you need to know about breast awareness and share this important information with your family, friends, and colleagues.
Author: Dr. Joy Parkinson