Fewer women are getting mammograms. Facilities offering mammograms are closing. Mammogram machine usage is declining. And we don't really know why.

"We're heading in the wrong direction," says Carol Lee, professor of radiology at Yale University School of Medicine and chair of the American College of Radiology's commission on breast imaging.

"If this decline holds up, it will be very worrisome," she says.

"We're looking at a possible increase in deaths if we see this continue," according to Diana Balma, vice president of public policy at Susan G. Komen for the Cure.

Studies don't show which women -- rich or poor, young or old, educated or uneducated -- are skipping these critical screenings, but there are a few possible reasons for this dangerous drop.

Think about this:

Perhaps there are fewer facilities, staffed by fewer radiologists and technologists due to high lawsuit rates and modest reimbursement. This is scary -- because the number of women old enough to get screened is increasing.

Women may be missing out on all sorts of necessary medical care because of inadequate health insurance or other access problems.

Women may be choosing, for whatever reasons, not to get mammograms, despite strong public urging that women age 40 and older get screened one time every year.

And now think about this:

Recent news about declining breast cancer rates may not be all that good. It may not be that fewer women are developing breast cancer. It may simply be that fewer women are getting early diagnoses because of irregular or nonexistent screening.

Researchers have identified a damaged gene -- BRIP1 -- that doubles the risk of familial breast cancer in a small percentage of women. BRIP1 is a DNA repair gene that can lead to uncontrollable cell growth if not functioning properly. Researchers have concluded that the damaged gene increases risk for breast cancer from eight to 16 percent by age 70.

These findings won't change patient care but they may offer comfort to women who develop breast cancer and cannot pinpoint the occurrence to the commonly mutated BRCA1 and BRCA2 genes -- mutations that are responsible for the disease 80 percent of the time. And while the study of BRIP1 does add to the pool of research on breast cancer, it does not warrant screening at this time. It's just a small piece of the puzzle that one day may prove significant. For now, the risk of breast cancer resulting from a damaged BRIP1 gene is modest.

Dr. Chandra Belani, Professor of Medicine and Oncology at the University of Pittsburg Cancer Institute, is a leader in the study of lung cancer. During a podcast interview, Belani shares some thoughts on the state of lung cancer -- currently the most common cause of cancer death in the United States.

Belani reveals that progress in the areas of lung cancer prevention, screening, diagnosis, and treatment can best be described as modest. There has been some progress -- and there are many on-going studies in these areas -- but there are no major breakthrough stories. Belani says there has been modest progress in diagnosis with the use of CT scans and PET scans -- and a combination of the two. There has been modest progress in chemotherapy treatment options. There has been no significant advance in detection -- and prevention is mostly in the hands of each individual since 90 percent of lung cancer cases are related to smoking.

Belani shares that true achievement would come with the discovery of a biomarker to detect lung cancer early and to lower overall mortality rates. He would also like to determine why he is seeing an increase in lung cancer cases among non-smokers.

The bar is being raised, says Belani. But it's slow going.