The percentage of American women getting mammograms has dropped slightly in the past few years, in what health officials said Thursday is a troubling sign that the battle against breast cancer may be flagging. The share of women 40 and older who said they had a mammogram in the previous two years slipped from 76.4 percent to 74.6 percent from 2000 to 2005, according to a study released by the Centers for Disease Control and Prevention. The rate had risen dramatically in the past two decades, from 29 percent in 1987, according to American Cancer Society statistics. The CDC and other researchers said possible explanations for the drop include a shortage of mammography screening centers and specialists, and a lack of health insurance among patients. Dr. Len Lichtenfeld, the cancer society's deputy chief medical officer, said the decline may reflect complacency among women. "This is a group of women who have 'grown up' with mammography as they've aged, they've perhaps had it done many times over the years and they've decided, 'Well, it's been OK, maybe I can put it off for a while,'" he said. He warned that the recently reported declines in breast cancer incidence rates and cancer deaths are at risk if the decline continues. "If we don't pay attention now, we run the risk of seeing some of the gains we've made reversed," he said.