Mammogram rates not falling for women 40 to 49, despite U.S. advice

April 24, 2013 | by Hiu Chung So

Since 2009, the U.S. Preventive Services Task Force (USPSTF) has recommended routine mammograms only for women age 50 and older. But a study published in Cancer on April 19 found that despite those recommendations, screening rates among women age 40 to 49 have not fallen.

 

Mammogram rates among women ages 40-49 have not change, despite recommendations against them from the US Preventive Services Task Force in 2009. Mammogram rates among women ages 40 to 49 have not changed, despite recommendations against them from the US Preventive Services Task Force in 2009.

 

In fact, between 2008 and 2011, the screening rate for that age group has risen slightly, from 46.1 percent to 47.5 percent.

Looking at this data, the study’s authors speculated that the rate may have stayed stagnant due to conflicting screening guidelines from other professional organizations.

The American Cancer Society and the National Comprehensive Cancer Network both recommend annual mammograms for women starting at age 40. But the USPSTF suggested that women between 40 and 49 talk with their doctors about the benefits and risks of mammograms, and personal risk factors — such as a genetic mutation or a family history of breast cancer — that may warrant earlier, more frequent screenings.

In making its recommendation, the USPSTF evaluated breast cancer screening, incidence and mortality data. The task force considered the lower incidence of breast cancer in young women and the negative impact of earlier, more frequent screenings, particularly  “false positives” that can result in unnecessary costs, additional tests and emotional burden.

Providing external commentary to WebMD, Joanne Mortimer, M.D., director of City of Hope’s Women’s Cancers Program, said she is “not surprised” by the findings.

On top of differing guidelines, Mortimer said, “it takes years for doctors to change their practice.”

Further, many clinicians may not be comfortable forgoing the test, she said, especially if it results in a lawsuit due to an undetected cancer.

And while the screening rates may not have changed, USPSTF’s advice might; it is slated to re-evaluate this recommendation in 2014. In the meantime, the preventive care provision of the Affordable Care Act ensures coverage of mammograms every one to two years for women over 40.

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