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On July 6, this report was posted as an MMWR Early Release on the MMWR website (

Background: Breast cancer remains the second leading cause of cancer deaths for women in the United States.

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The findings in this report are subject to at least three limitations.

First, because BRFSS is a telephone survey of residential households, only women in households with landline telephones participated; therefore, the results might not be representative of all women.

The program has provided high quality screening, diagnostic and treatment services for the past 20 years.

Mammography utilization is influenced by multiple factors, including patient and provider characteristics, health-care norms, and access to and availability of health-care services. For example, the screening rate varied considerably by geography and was lowest in west-central states, the states with the lowest population densities A study from Texas highlighted the association between mammography supply and mammography use at the county level.

Among the lowest prevalences reported were those by women aged 50--59 years (79.9%), persons who did not finish high school (72.6%), American Indian/Alaska Natives (70.4%), those with annual household income 40 years who had a mammogram within the past 2 years.* The target was met in 2003 and exceeded by 11 percentage points in 2008.

Nonetheless, approximately 7 million eligible women in the United States are not being screened regularly, and they remain at greater risk of death from breast cancer.

LC Richardson, MD, SH Rim, MPH, M Plescia, MD, Div of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC. Alternate Text: The figure above shows the percentage of women aged 50-74 years who reported receiving up-to-date mammography, by state in the, United States in 2008.

• One in five women aged 50--74 is not up-to-date with mammograms. Mammography screening prevalence varied by state, with the highest mammography use in the northeastern United States.

Among states, screening prevalence ranged from 72.1% in Nevada to 89.8% in Massachusetts. Percentage of women aged 50--74 years who reported receiving up-to-date* mammography --- Behavioral Risk Factor Surveillance System (BRFSS), United States, 1997, 1998, 1999, 2000, 2002, 2004, 2006, and 2008 Percentages standardized to the age distribution in the 2008 BRFSS survey.

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