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 Under the U.S. Preventive Services Task Force guidelines, mammogram
screening every two years for women 50 to 74 got a grade of "B",
meaning doctors should offer the service. Screening for women in
their 40s got a "C" grade, meaning doctors should offer the service
for select patients, depending on individual circumstances.
Critics have stressed that keeping 50 as the starting age for
screening could threaten insurance coverage for millions of women
aged 40 to 49. That is because insurers are not required to cover
screening for women in their 40s, according to provisions in the
Affordable Care Act.
Lawmakers, however, have already weighed in, adding an amendment to
the 2016 U.S. spending bill that guarantees coverage for mammograms
for women starting at age 40 through 2018.
Debate over the proper age at which doctors should start offering
screening mammograms has raged since the task force first issued its
recommendation in 2009. At the time, the panel cited evidence
showing that the harm from over screening outweighed the benefits in
cancer prevention.
Since that time, the task force has maintained that 50 is the best
age to start routine screening. But it has left the door open for
individuals who might benefit from screening starting at age 40.
"The task force believes that the science supports a range of
individual choices for women to make for when to start screening,
all the way from starting at age 40 or waiting until age 50, or
anywhere in-between," said Dr. Michael LeFevre of the University of
Missouri School of Medicine, Columbia, former chair of the
government-backed panel.
The new, more inclusive wording of the guidelines is more in line
with new recommendations from other cancer groups, such as the
American Cancer Society. The society released new breast cancer
screening guidelines in October pushing back the starting age for
screening mammograms to 45 from 40, and recommending that younger
women should have the choice to start screening as early as 40.
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Dr. Otis Brawley, chief medical officer for the American Cancer
Society, said he is happy with the Task Force's conclusions.
"We all recognize that the patient should be empowered and the
patient should control her own body," he said.
According to the task force, screening 10,000 women in their 50s
will result in eight fewer deaths, versus four fewer deaths for
women who start screening at age 40.
Possible harms of breast cancer screening include unnecessary
treatment for potentially harmless forms of breast cancer, incorrect
results known as false positives and unnecessary additional testing.
As long as women understand the balance between benefits and harms,
they can make a reasonable decision to start screening anytime in
their 40s, LeFevre said.
Women with mothers or sisters with a history of breast cancer may
benefit more from screening in their 40s, according to the task
force.
For the full report: http://bit.ly/Ms1ZbQ
(Reporting by Julie Steenhuysen; Editing by Dan Grebler)
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