Fueled by new evidence, the debate continues about whether women younger than age 50 should undergo regular screening for breast cancer.
New research shows that women in their 40s who receive regular mammograms substantially lower their risk of dying from breast cancer. In a study involving 16.1 million Swedish women aged 40 to 49 years, those who were screened for breast cancer had a 26% lower risk of death.
The results, which were published in Cancer, the journal of the American Cancer Society, add to the growing body of knowledge on the effectiveness of mammograms. Still, they may not provide a definitive answer on the question that weighs heavily on the minds of health care providers, advocacy groups, and government health officials: at what age should routine screening begin?
The US Preventive Services Task Force (USPSTF), an independent panel to which many health plans look for guidance on preventive care, ignited a controversy last year when it attempted to answer this question after a review of medical data. The panel’s unpopular recommendation was to raise the minimum age for routine screening from age 40 to 50 for most women.
USPSTF maintained that the change would prevent an excess of false positive results, as well as the added costs, stress, and anxiety that accompany unnecessary biopsies, which are common among younger women who undergo screening.
As CNN reported, a paper published recently in the New England Journal of Medicine adds another wrinkle: for women older than 50 years of age, routine mammograms may not be as effective as previously thought.
Despite the mounting evidence on both sides of the debate, the American Cancer Society and the US Department of Health & Human Services are clear in their recommendation: beginning at age 40, all women should consider having a mammogram every 1 to 2 years.
“Each woman should talk with her health care provider to determine her personal risk for breast cancer and what screening schedule is best for her,” said the US Department of Health and Human Services Secretary Kathleen Sebelius in a statement recognizing October as Breast Cancer Awareness Month.
Those conversations should be made easier by the Patient Protection and Affordable Care Act, which requires insurance providers to cover the entire cost of recommended preventive services. Other elements of the law will provide annual funding to support research led by the National Institutes of Health to find new methods of identifying at-risk women.
“Through all these important initiatives to promote health and prevent disease, and through ongoing research, we will be able to save more lives and improve the quality of life for all Americans with breast cancer,” Sebelius said.
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