Difficulty of access and confusion about mammogram recommendations both feed into Wyoming's ranking as second lowest in the nation when it comes to the numbers of women taking advantage of screenings for breast cancer.

"The most recent year we have for rankings of overall screening rates was 2010 and our overall screening rate for women, 40 and older, was 67.3 percent, which isn't very much of a change from 2008 when we were last. This year we're 48th."

Kim Deti, for the Wyoming Department of Health, says conflicting views on the value of mammograms in saving lives may be part of the reason, but also the long distances many women need to travel in the state to get a mammogram play into the low numbers.

Deti says the Wyoming Comprehensive Cancer Consortium recommends all women consider mammograms every one to two years beginning at age 40, "but we also say that it's really important that folks talk to the medical professional that they see regularly for information about those mammograms, about the screening, and also for more information about clinical and self breast exams."

While the state’s number of diagnosed female breast cancer cases has gone up in recent years, Deti says, this may largely be due to improved early detection technology.

"As technology improves it's able to detect the cancers at an earlier state. So we might have a little bit higher incident rate, but we've also seen a decrease in our death rate from breast cancer and that's the good news."

Deti stresses that there are options available to any woman in Wyoming who wants to take advantage of screening. The Wyoming Department of Health’s Breast and Cervical Cancer Early Detection Program, also known as Women’s Health Source, pays for breast screening and diagnostic tests for women who do not have health insurance, are low income, and are age 50-64. Women under 50 may also qualify.