Fewer than half of American women over 65 seem to be getting the mammograms they need to catch breast cancer in its earliest stages, and a key reason may be the lack of health insurance to supplement Medicare.

An analysis of Medicare bills from 1991 and 1992 by Dr. Jan Blustein of the Division of Health Policy Management at Columbia University's School of Public Health found that although Medicare pays for breast cancer screening every second year, only 45 percent of women who received supplemental health insurance through their employers were getting the test.The analysis, to be published in Thursday's New England Journal of Medicine, showed that among other groups of women, the mammography rates were even lower - 40 percent for those who paid for their supplemental insurance; 24 percent among women covered by Medicaid and 14 percent among women who had no supplemental insurance.

"For many older women, screening mammography may have been an unaffordable luxury, particularly with competing out-of-pocket medical expenses, including prescription drugs, eyeglasses and dental care," said Blustein.

Join the Conversation
Looking for comments?
Find comments in their new home! Click the buttons at the top or within the article to view them — or use the button below for quick access.