New Screening Guidelines are Harmful to Women's Health
In the fall of 2009, national breast cancer screening guidelines were updated. As stated in the Annals of Internal Medicine, the U.S. Preventive Services Task Force (USPSTF) recommended radical changes in the clinical guidelines for screening mammography. These recommendations include:
1. Screening mammography should not be performed routinely for all women age 40-49 years.
2. Women ages 50-74 years should have mammography every two years.
3. There is not enough evidence to recommend for or against screening mammography after age 74 years.
In reaction to these recommendations, the Society of Breast Imaging, the American College of Radiology, and the American Cancer Society have issued statements strongly opposing these guidelines.
The breast imagers of Diversified Radiology of Colorado, Rose Medical Center's imaging partner, also strongly oppose these recommendations. Here's why:
While the incidence of breast cancer is lower for women in their 40s compared to women overall, the benefits of screening mammography are actually higher for them. Studies have shown that the risk of dying has been reduced as much as 30-45% in this age group. The USPSTF has concluded that because there are fewer women diagnosed in their 40s, the cost to screen for these cancers outweighs the benefits for these women.
For the last two decades there has been a decline in the number of deaths from breast cancer that has been directly linked to the implementation of current screening guidelines. These guidelines specifically changed screening from two years to every year and started screening women at an earlier age. What the USPSTF is recommending is a complete reversal of the advances we have made.
Women will die unnecessarily because of these new recommendations. The highest increase of breast cancer has been seen in women under 50. In some of our Colorado locations, the diagnosis of breast cancer in women under 50 has been as high as 37% of the population screened. Breast cancer is the most common cancer in women and the second leading cause of death in women overall and the leading cause of death in young women. This has been attributed to tumors being more aggressive in younger age groups.
The goal of screening is to find small, nonpalpable (cannot be felt by the hand) tumors in order to have the best outcome. The new USPSTF guidelines will allow more time between mammograms and therefore more women will come in when they are symptomatic and with larger tumors. This will diminish our ability to identify breast cancer in its earliest stages, which most successfully leads to a cure. These guidelines will directly affect breast cancer survival negatively and increase patients' chances of dying from the disease.
