U.S. Preventive Services Task Force Says No Mammograms until 50
In a surprising report released in November, 2009, the U.S. Preventive Services Task Force (USPSTF) has recommended against mammograms for women under 50 years old. The government panel, comprised of doctors and scientists has concluded that less benefit and more harm is done with annual mammograms in women ages 40 to 49 years old, leading to more false alarms and unneeded biopsies without increasing chances of survival. According to the USPSTF rationale, the harms of detection and early intervention include psychological harm, unnecessary tests and biopsies and inconvenience caused by false positives.
The Task Force went on to say that women should not perform self breast exams, should not be taught how to do them and that there is insufficient evidence to support the value of breast exams performed by doctors.
The government's recommendations are contrary to the American Cancer Society's position on mammography. On Monday, November 16, 2009, The ACS reiterated its recommendation for annual screenings for women beginning at age 40, and bi-annual screenings for women 50 years and older.
Breast cancer is the second leading cause of death in women in the United States. The government acknowledges that widespread screening has reduced the mortality rate, but more so in women over 50, with women ages 60 to 69 being the most likely to benefit.This recommendation statement excludes widespread screening for women in their forties who do not have an increased risk for breast cancer because of family history or a history of chest radiation. Women with higher risk factors should begin earlier screening.
While the Task Force recognizes equal benefit of screenings for women in the forties and women in their fifties, the recommendation against screening for the younger women is based on the incidence of breast cancer in each age group. Older women are more likely to get breast cancer than younger women. It encourages women to make informed decisions about when to start regular mammography screenings.
Women interviewed across the country seem to be leaning toward acceptance of the American Cancer Society's mammogram recommendations. Many feel that is better to be safe than sorry, and have cited personal experiences with women in their thirties and early forties who have been diagnosed with advanced breast cancer.
The government panel recommendations are in line with the international community. The World Health Organization recommends bi-annual screenings beginning at age 50, and Britain suggests screenings every three years. The American Cancer Society challenges those positions.
Dr. Otis Brawley, the ACS 's chief medical officer wrote,"The task force advice is based on its conclusion that screening 1,300 women in their 50s to save one life is worth it, but that screening 1,900 women in their 40s to save a life is not." He went on to say that the government's position "is essentially telling women that mammography at age 40 to 49 saves lives, just not enough of them."
When Should Women Start Getting Mammograms?
Which organization's recommendations for mammograms do you agree with?
- How to Decide When to Start Getting Mammograms | eHow.com
How to Decide When to Start Getting Mammograms. Breast cancer is the second leading cause of death for women in the United States. Early detection with mammograms has increased the breast cancer survival rate significantly. For nearly two...
- Screening for Breast Cancer: Recommendation Statement
Recommendations on screening for breast cancer from the U.S. Preventive Services Task Force (USPSTF).