More women are being encouraged to pay for breast cancer x-rays from when they turn 40, after it was found that many younger women do not know how common the disease is at their age.
The Breast Cancer Foundation has released results of a national survey which found the majority of women in their early 40s have not had a mammogram. And two-thirds of women in their 20s or 30s don't know breast cancer is the commonest cancer among women in their age group.
"We all apply sunscreen," said foundation chief executive Evangelia Henderson, "and many women have regular cervical smears from a young age, yet when it comes to be being proactive about their breast health, they don't know their risk, so they're not taking steps to minimise it."
The foundation says breast cancer accounts for 28 per cent of cancers among women in their 20s and 30s. Melanoma is second at 19 per cent.
Health Ministry figures show that in 2009, 149 women aged 20 to 39 were diagnosed with breast cancer - 5 per cent of the 2759 women of all ages diagnosed.
Among New Zealand women, breast cancer is the most commonly diagnosed cancer and, with more than 600 deaths a year, the second most common cause of cancer death after lung cancer.
The Government pays for women aged 45 to 69 to have a screening mammogram - a specialised x-ray - every two years.
In Australia, publicly-funded breast screening is available to women from the age of 40, but is primarily aimed at those aged 50 to 69. Britain offers screening from 50, but is reducing the entry age to 47.
In New Zealand, the foundation advises that as well as women regularly checking their own breasts, and joining the state-paid programme when eligible, those aged 40 to 49 should have a mammogram every year. At a private clinic, the x-rays cost at least $145, and usually around $160.
The foundation acknowledges that the evidence for mammography screening in the 40s is "less compelling" than for older women, but says the consistent trend of clinical trials is that screening the younger group reduces their risk of breast cancer death by 15 to 17 per cent.
The trials in the older age groups have shown a reduction of at least double that.
Leading cancer epidemiologist Associate Professor Brian Cox, of Otago University, does not support mammography screening in women in younger age groups.
"On balance the evidence is not very conclusive and it's insufficient at this point to advocate that women should be screened from the age of 40 ... The evidence [for screening women aged 45 to 50] is pretty weak as well."
But foundation medical spokeswoman Belinda Scott, a breast surgeon, strongly disagreed with Dr Cox.
She said: "Women need to have the choice and need to be advised mammograms from the age of 40 can save lives."
Early mammogram averts cancer misery
It was no more than a vague feeling that led Rose Wharepapa to have her breasts x-rayed six years ago - a decision she believes spared her the worst miseries of breast cancer.
"I had started training a woman who had breast cancer," said Mrs Wharepapa, an Auckland mother and personal trainer at a New Lynn gym.
"I thought that was why I had the feeling - making me more aware of it. I went to a doctor for a referral for a mammogram. I carried it around for months in my bag and didn't do anything about it.
"I just kept on getting reminders of things. I would pick up a women's magazine and there would be an article on breast cancer; it would be on TV; the breast cancer [screening] bus would come to Les Mills."
Now 49, Mrs Wharepapa had her mammogram at a private hospital when she was 43, two years earlier than when she would have become eligible for the state-funded breast screening programme.
But she is thankful she did. The x-ray showed an abnormality in her right breast which led to a tissue biopsy.
From this, a diagnosis was made of ductal carcinoma in situ, a pre-invasive lesion that can spread.
Because of the risk of the abnormal cells spreading to her left breast, she had a double mastectomy, a decision she does not regret.
"I would rather be alive than have my breasts," she said. said.
But her cancer experience was not without difficulty.
She had breast reconstruction surgery, which she said became a nightmare. She had infections and problems with the reconstruction.
She had to have several corrective operations spread over more than two years.
What is her message to other women?
"Get a mammogram. I want people to tell their sisters, their mothers, their aunties that it's so important to get a mammogram."
* 35 per cent do not know breast cancer is the commonest cancer for women in their age group
* 12 per cent never check their breasts for changes
* 33 per cent have never asked about family history of breast cancer
* 30 per cent have had a mammogram
* 60 per cent of those who have had a mammogram said the main reason was they were worried about a lump or other breast change
* 45 per cent of those who have not had a mammogram said the main reason was they were too young.
Colmar Brunton survey of 500 women for the Breast Cancer Foundation.