Survey: More than 1 in 3 women have skipped or delayed a recommended mammogram

More than 1 in 3 U.S. women aged 35 to 75 have skipped or delayed a recommended mammogram, and a direct recommendation from their physician may be one of the most effective ways to get them back on schedule, according to a new survey from Hologic.

The survey of 1,000 women found that 37% had skipped or delayed a recommended screening. Among those women, 4 in 10 went more than two years without a mammogram.

When overdue respondents were asked what would most motivate them to get screened, nearly 1 in 4 pointed to a direct recommendation from their doctor, a finding the company said underscores the role health care providers play in encouraging screening.

“These findings show that what stands between a woman and a potentially lifesaving mammogram is rarely a single obstacle,” said Jyoti Gupta, Ph.D., CEO of Hologic’s Breast and Skeletal Health Solutions business. “More often, it’s a missed reminder, a conversation that never happened or uncertainty about which screenings she needs and what they may cost her.”

Gupta added that because breast cancer outcomes are so closely tied to early detection, she encourages every woman to ask her health care provider which screenings are right for her and to make that appointment a priority.

Breast cancer is the most commonly diagnosed cancer among women in the U.S., and it has a 99% survival rate when caught at an early, localized stage, according to the company.

Where screening breaks down

The survey identified several gaps that can stand between women and regular screening:

• Provider engagement. Half of women surveyed do not routinely see an OB-GYN, and 20% of eligible women who have never been screened said they have never been told they need a mammogram.
• Reminders. Twenty-one percent said getting a recommended mammogram is not top of mind.
• Cost. More than one-third of respondents (36%) do not know, or do not believe, that preventive screening mammograms are covered at no cost under most insurance plans.
• Social barriers. Among women facing transportation barriers, 59% have skipped a mammogram, compared with 31% of those without such barriers. Similar gaps appeared among women experiencing housing instability (57% vs. 33%) and food insecurity (56% vs. 29%).
• Radiation concerns. Forty-three percent of women believe, or are unsure whether, mammograms expose them to dangerous levels of radiation. According to the company, a standard screening mammogram delivers about 0.4 mSv, roughly what an average person receives from natural sources over one to two months.

Breast density remains poorly understood

The survey also found persistent gaps in women’s understanding of breast density, despite recent awareness efforts that include U.S. Food and Drug Administration standards requiring mammography facilities to notify patients about their breast density.

Fifty-seven percent of respondents did not know that having dense breasts increases breast cancer risk, and 66% believe dense breasts can be detected by touch.

The gaps continue after screening. Among women who have had a mammogram, 37% said they did not have a meaningful conversation about breast density following their most recent screening, and 40% of women with dense breasts said they were never recommended additional screening.

According to Hologic, the findings point to a need for clear, accessible education about when to get screened, what preventive screening may cost and how to separate fact from common misconceptions.

The company said it is continuing its #BustTheMyth patient education campaign for a third consecutive year. The campaign delivers fact-based information about breast cancer, breast density and screening through social and traditional media, informational emails, videos, educational materials and posters for physician offices, and features real women from around the world.

Screening gaps put pressure on primary care

The survey arrives as physicians face growing expectations to close preventive care gaps across their patient panels, particularly for patients who do not see a specialist regularly. For many women who do not routinely visit an OB-GYN, the primary care visit may be the main, or only, opportunity for a clinician to raise screening.

Breast cancer screening guidance has also shifted in recent years. The U.S. Preventive Services Task Force in 2024 finalized a recommendation for biennial screening mammography beginning at age 40 for women at average risk, lowering the starting age from 50. That change expanded the pool of eligible patients and, with it, the number of women who may be due or overdue for screening at any given time.

At the same time, federal breast density notification requirements, which took effect nationwide in 2024, mean more patients are receiving density information directly in their mammography reports. That can prompt follow-up questions about supplemental imaging and individual risk that often land with the ordering physician.

Practices have increasingly turned to population health tools, such as registry-based outreach, automated reminders and care gap flags in the electronic health record, to identify patients who have fallen behind on preventive services. Social determinants of health, including transportation and housing instability, are also drawing more attention as factors in missed preventive care, with some health systems pairing screening outreach with scheduling help, transportation assistance or mobile screening units.