New Breast Cancer Screening Guidelines Are A Step In The Right Direction, But One More Step Is Needed
[ad_1]
Yesterday, on May 9, 2023, the United States Preventive Services Task Force (USPSTF) updated their guidelines for breast cancer screening. Currently, the USPSTF has recommended that women with average risk of breast cancer get screened every other year between the ages of 50-74. Any screening for women prior to the age of 50 can be done on an individual basis. However, the new proposed guidelines now recommend screening to start at the age of 40, with continued screening every other year until the age of 74 for those at average risk of breast cancer.
The new draft guidelines represent a big step in the right direction since breast cancer is the most common cancer in women in the United States and 9% of all new cases of breast cancer occur in women under the age of 45. Breast cancer in younger women is more likely to be more aggressive at diagnosis and difficult to treat, thus dropping the screening age to 40 represents a milestone in preventing breast cancer diagnoses and ultimately saving lives.
The USPSTF could have gone a step further and recommended annual screening for breast cancer with mammography starting at the age of 40, as many other national societies have recommended such as the American College of Radiology and the Society of Breast Imaging. Data shows that annual mammography starting at the age of 40 until the age of 84 actually saves lives, reducing mortality up to 40% when compared to no screening. This, in itself, should provide a strong impetus for USPSTF guidelines to recommend annual screening as opposed to biennial screening.
Annual mammography screening could also go a long way in promoting health equity. Black women are 40%more likely to die of breast cancer when compared to White women. A research paper published in the Annals of Internal Medicine compared tradeoffs of screening strategies between Black women and White women under current guidelines. One among many of the findings include a 57% breast cancer death disparity reduction for Black women compared to White women if biennial screening were to occur for women starting at the age of 40 until 74. When screening occurred annually for women starting at the age of 40 until 74, breast cancer death disparities were reduced to 97.7% for Black women, although the number of false-positives (screening test that shows a cancer when in fact none exists) nearly doubled when compared to biennial screening. USPSTF task force members must weigh the benefits and harms of annual screening, taking into account that nearly all breast cancer death disparities could disappear for Black women if annual screening were to be recommended.
The draft guidelines by the USPSTF are available for public comment until June 6th. In addition to annual screening starting at the age of 40, other considerations could include proposing guidelines for women who are older than the age of 74 for screening. Nearly 20% of women diagnosed with breast cancer are over the age of 75. Furthermore, although it is well known that those with dense breasts have a higher risk of breast cancer, no specific recommendations were made in the draft guidelines for this specific group. Specific recommendations could help alleviate anxiety in these groups of women.
Annual screening at the age of 40 could and will save more lives than biennial screening starting at the age of 40. The USPSTF has less than a month to take this final step.
[ad_2]
Source link
