Introduction In Brazil, since 2004, mammography screening for breast cancer is recommended every 2 years for women aged 50–69. This study examined the effect of external factors—population characteristics and geographic location—on the chances of having a mammogram, in 2003 and 2008.

Methods Patterns of mammography use were examined for women aged 40 years or more as reported in the health supplements of the Brazilian National Household Survey (PNAD) for 2003 and 2008, using multivariate logistic regression. Covariates included were age, race/colour, education, income, self-reported health, insurance, usual source of care, position in the family, having a medical consultation in the last 12 months, urbanisation, and region of residence.

Results About 52.6% in 2003 and 67.4% in 2008 of women aged 40 or older reported receipt of a mammogram. Compared to women 40–49 years old, those aged 50–69 had higher odds of having been screened (1.076 in 2003 and 1.354 in 2008), those aged 70 or older had lower odds (0.513 in 2003 and 0.625 in 2008). The odds increase with family income, education, being married, seeing a physician. Having insurance doubles the odds, as does living in a metropolitan area (3.620 in 2003 and 3.322 in 2008). Compared to the North region, residents in all other regions had larger odds.

Conclusions The age-group targeted by the national policy had marked increase in screening coverage. There are indications of a lessening in inequalities due to income levels, but disparities linked to regional variation have not been reduced.