Nearly 60% of women ages 40 and up aren’t getting annual mammograms, according to a survey from MedStar Health. And 23% have never had a mammogram.

The finding comes even after a US government task force earlier this year dropped the age recommendation for getting regular mammogram screenings for breast cancer from 50 years old to 40 years old.

According to the American Cancer Society, breast cancer cases have increased 0.5% in recent years. The good news is that while cases have gone up, death rates have steadily decreased since 1989, dropping 43% through 2020. But the group says it’s not just better treatments that are leading to better outcomes — it is also “the result of finding breast cancer earlier through screening and increased awareness.”

The survey also found that women are not getting mammogram screenings because they didn’t “get around to it” (34%), they had gotten a normal mammogram in the past (21%), or they did not have a family history of breast cancer (17%).

You can check out your breast cancer risk using this calculator, which is recommended by the American College of Radiology. It considers different factors, such as age and family history, with an aim to help you develop a risk management plan with your provider.