Trends in Mammography Use Among Women Aged 40 to 74 Years in the US, 2002-2022

Objective: To analyze mammography use trends in US women aged 40 to 49 and 50 to 74 years from 2002 to 2022. Among 2,619,292 US women, mammography use showed a downward trend, with nonsignificant biennial changes of -0.54% for ages 40 to 49 years and -0.16% for ages 50 to 74 years from 2002 to 2022. Declines were significant among young women without health insurance (-1.54%), current smokers (-1.36%), unmarried women (-1.10%; and non-Hispanic White women (-0.58%). Following the 2009 USPSTF recommendation, mammography use decreased significantly among younger non-Hispanic White (-0.88%), Asian (-2.45%), and uninsured (-2.39%) women, with no significant reduction among non-Hispanic Black women (-0.59%). Across both age groups, mammography use was consistently lower in Western than in Eastern states. In this cross-sectional study, mammography use did not significantly decline in the overall population; however, significant reductions were observed among non-Hispanic White, Asian, and uninsured women aged 40 to 49 years from 2010 to 2022. These findings highlight the need for clear, risk-based screening communication and targeted strategies to promote guideline-concordant decision-making, particularly among younger women.