Can we fulfill the recommendation of annual recommendation of breast cancer screening? Mammography capacity in Chicago

Rationale: It is recommended that women over 40 have annual mammograms. A newly created initiative in Chicago has as one of its goals to greatly increase access to mammography. We wondered if there would be adequate capacity if our outreach efforts were successful. A review of the literature and communication with other locations revealed that mammography capacity assessments did not exist for any geographic area in the US. Methods: We surveyed all 86 local institutions that were FDA approved to perform mammograms. With the aid of a unique city-wide collaboration we obtained an overall response rate of 84% for our survey which investigated how many mammograms each institution performs each year and how close each site was to reaching its capacity. Finally, we used the 2000 US Census to determine the age eligible population (i.e., women > 40). Results: The 2000 Census revealed that 588,000 women were eligible for screening mammograms annually in Chicago. Our survey found that approximately 205,000 mammograms were performed for city residents in 2008. Thus only 35% of the age eligible population received a mammogram. In addition, even if every site ran at their maximum capacity only about 50% of age eligible women would be able to get a mammogram. Conclusions: Chicago is not equipped to provide mammography services to all women who are eligible for them. There thus appears to be a mixed message between public health efforts that urge early detection for breast cancer and the reality women face in accessing breast health care.