An influential task force today recommended that women start getting mammograms at age 40 and have breast cancer screenings every two years until age 74.
 |
| The task force says women should start breast cancer screening and undergo mammography at this point. |
The latest guidance from the US Preventive Services Task Force, released on Tuesday, lowers the recommended screening age for women at average risk of breast cancer by 10 years. The working group said medical evidence from studies suggests that breast tissue exams every two years provide a "moderate net benefit" for women up to age 74.
However, the task force said there was not enough evidence to recommend regular testing for women over 75. Additional screening methods such as ultrasound or MRI for women with dense breast tissue were also not recommended. The panel stated that physicians should use their judgment when ordering screening for these populations.
Insurance coverage begins based on the recommendation of the special committee
The Affordable Care Act requires insurance companies to cover preventive care that receives an "A" or "B" grade from the Preventive Services Task Force, an independent advisory panel that evaluates medical tests, treatments, and services. It is mandatory.
For women whose average risk is between the ages of 40 and 74, the task force assigned a grade of "B" for mammography screening. This screening recommendation does not apply to high-risk women who have previously been diagnosed with breast cancer or their genetic mutations, such as BRCA1 or BRCA2.
For women whose average risk is between the ages of 40 and 74, the task force assigned a grade of "B" for mammography screening. This screening recommendation does not apply to high-risk women who have previously been diagnosed with breast cancer or their genetic mutations, such as BRCA1 or BRCA2.
The panel reviewed several large medical studies and concluded that the "net benefits" of such biennial testing outweigh the risks. These can include anxiety-inducing false positives, unnecessary biopsies, radiation exposure, etc. since mammography requires his x-ray technology.
Disparities persist in breast cancer, the second most deadly cancer in women
Breast cancer is the second most common cancer in women and also has the second highest mortality rate. In 2023, an estimated 43,170 women will die from breast cancer. White women have the highest incidence of breast cancer. Black women have the highest mortality rate from breast cancer, and are 40% more likely to die from breast cancer than white women. A report published in the Journal of the American Medical Association (JAMA) details the task force's recommendations and finds significant disparities in access to follow-up and treatment. The study reported that black women's self-reported mammography screening rates were "same or higher than all women," but found disparities in follow-up and treatment after mammography screening.
The study found that the incidence of triple-negative cancer (a type of breast cancer that is more aggressive and diagnosed at a later stage) was twice as high in black women as in white women. To reduce disparities, the task force said it is important that everyone diagnosed with an abnormal mammogram receives equal follow-up and testing, as well as all recommended biopsies and treatments.
The study found that the incidence of triple-negative cancer (a type of breast cancer that is more aggressive and diagnosed at a later stage) was twice as high in black women as in white women. To reduce disparities, the task force said it is important that everyone diagnosed with an abnormal mammogram receives equal follow-up and testing, as well as all recommended biopsies and treatments.
No testing for women over 75
Karen Knudsen, CEO of the American Cancer Society, said the task force's recommendations send a "strong message to referring physicians and women that breast cancer screening should begin earlier than age 50." said.
However, Knudsen was disappointed that the task force did not recommend screening tests for women over 75.
"Millions of women over the age of 75 are in excellent health and can be expected to live many more years while their risk of breast cancer remains high," Knudsen said. He said the American Cancer Society "does not support stopping testing for people of any age who have at least 10 years to live."
Dr. Douglas Marks, a medical oncologist at New York University Langone Perlmutter Cancer Center in New York City, said lowering the screening age to 40 is a step forward from the National Comprehensive Cancer Network, the American College of Obstetricians and Gynecologists, the American College of Obstetricians and Gynecologists, and others. said that it is consistent with the recommendations of other organizations. of radiology.
He also said that after a 2016 task force proposed that routine testing start at age 50, the task force's draft recommendations last year suggested a move to start testing women 10 years younger. he pointed out.
The new guidelines also state that both digital mammograms and 3D mammograms are effective screening techniques. The task force said there was insufficient evidence to support or oppose additional MRI testing. However, Marks pointed out that one study found that MRI can detect breast tumors early and prevent more advanced cancers.
"We need to pay attention to these other technologies and how they improve our ability to screen patients, at least to some degree," Marks said.
However, Knudsen was disappointed that the task force did not recommend screening tests for women over 75.
"Millions of women over the age of 75 are in excellent health and can be expected to live many more years while their risk of breast cancer remains high," Knudsen said. He said the American Cancer Society "does not support stopping testing for people of any age who have at least 10 years to live."
Dr. Douglas Marks, a medical oncologist at New York University Langone Perlmutter Cancer Center in New York City, said lowering the screening age to 40 is a step forward from the National Comprehensive Cancer Network, the American College of Obstetricians and Gynecologists, the American College of Obstetricians and Gynecologists, and others. said that it is consistent with the recommendations of other organizations. of radiology.
He also said that after a 2016 task force proposed that routine testing start at age 50, the task force's draft recommendations last year suggested a move to start testing women 10 years younger. he pointed out.
The new guidelines also state that both digital mammograms and 3D mammograms are effective screening techniques. The task force said there was insufficient evidence to support or oppose additional MRI testing. However, Marks pointed out that one study found that MRI can detect breast tumors early and prevent more advanced cancers.
"We need to pay attention to these other technologies and how they improve our ability to screen patients, at least to some degree," Marks said.
Should I have a mammogram once a year?
In an accompanying editorial published in JAMA with the task force's screening recommendations, Wendy A. Berg, a professor of radiology at the University of Pittsburgh Medical Center, said more lives could be saved by screening each year. Stated.
The task force's recommendations are "an important step forward, but they fail," Berg wrote. "Annual mammography is just as efficient as biennial mammography, but the overall benefit in years saved is greater."
Russell P. Harris, who served on the task force from 2003 to 2008, said last month that the task force's draft recommendations at the time were confusing to the public and "unlikely to result in increased testing with little likelihood of benefit." '', he wrote in the Annual Report of Internal Medicine. “And the potential for harm is clear.”
The task force's recommendations are "an important step forward, but they fail," Berg wrote. "Annual mammography is just as efficient as biennial mammography, but the overall benefit in years saved is greater."
Russell P. Harris, who served on the task force from 2003 to 2008, said last month that the task force's draft recommendations at the time were confusing to the public and "unlikely to result in increased testing with little likelihood of benefit." '', he wrote in the Annual Report of Internal Medicine. “And the potential for harm is clear.”
Post a Comment