Mammography screening rate drops among younger women
May 04, 2011
by Brendon Nafziger, DOTmed News Associate Editor
The mammography screening rate for women under 50 has fallen since the U.S. Preventive Services Task Force released its controversial 2009 guidelines cautioning against routine screening in younger women, according to a presentation at the American Roentgen Ray Society's annual meeting in Chicago this week.
A separate study also found that younger women who were screened had smaller and less aggressive cancers, suggesting that the USPSFT guidelines could worsen breast cancer survival, according to researchers.
However, the studies have not appeared in a peer-reviewed journal yet.
In November 2009, the influential USPSTF issued new recommendations for breast cancer screening, advising against routine mammograms for normal-risk women aged 40-49. It also called on women 50 and over to get screened once very two years, instead of annually.
Those recommendations drew criticism from the American Cancer Society, the American College of Radiology and some women's groups. But they seem to have had an impact on screening rates.
In a presentation at the ARRS meeting, Dr. Lara Hardesty, the chief of breast imaging at University of Colorado Hospital in Denver, said screening rates among younger women at her hospital have fallen 15 percent while remaining almost unchanged for older women.
At her hospital, 1,327 women 40-49 were screened before the guidelines, but only 1,122 after they were released, according to a WebMD summary of her presentation. For women 50 and above, the number was nearly unchanged: 4,479 women underwent screenings before the recommendations came out, and 4,498 after.
Hardesty also surveyed about 50 health care providers at her hospital, and found the number of providers recommending that younger women get routine screenings declined by more than half. Before the USPSTF released its guidelines, 56 percent recommended yearly screening for women 40-49. After the guidelines, that number fell to 20 percent. However, after the guidelines came out, 54 percent recommended one-on-one counseling about the risks and benefits of screening, as recommended by the USPSTF.
Finding cancer early
Another study also shared at the ARRS meeting, by Dr. Donna Plecha, chief of mammography at University Hospitals at Case Medical Center in Cleveland, found that cancers in young women caught by mammography were smaller and therefore likely easier to treat.
In her study, she reviewed records of 359 biopsies of women in their 40s who had screening mammograms at her hospital between 2008 and 2009. Of these women, about 15 percent had cancer -- cancers in an earlier and presumably more treatable stage, she said, according to a CNN report.
However, Dr. Virginia Moyer, the current chair of the USPSTF, said the study assumes catching some of the cancers earlier will actually save more lives, which might not be the case.
"The data that we have suggests that one in a thousand will benefit from mammograms in the 40-49 age," she told CNN. "There are whole lots of assumptions that are not supported by the data they presented."
A separate study also found that younger women who were screened had smaller and less aggressive cancers, suggesting that the USPSFT guidelines could worsen breast cancer survival, according to researchers.
However, the studies have not appeared in a peer-reviewed journal yet.
In November 2009, the influential USPSTF issued new recommendations for breast cancer screening, advising against routine mammograms for normal-risk women aged 40-49. It also called on women 50 and over to get screened once very two years, instead of annually.
Those recommendations drew criticism from the American Cancer Society, the American College of Radiology and some women's groups. But they seem to have had an impact on screening rates.
In a presentation at the ARRS meeting, Dr. Lara Hardesty, the chief of breast imaging at University of Colorado Hospital in Denver, said screening rates among younger women at her hospital have fallen 15 percent while remaining almost unchanged for older women.
At her hospital, 1,327 women 40-49 were screened before the guidelines, but only 1,122 after they were released, according to a WebMD summary of her presentation. For women 50 and above, the number was nearly unchanged: 4,479 women underwent screenings before the recommendations came out, and 4,498 after.
Hardesty also surveyed about 50 health care providers at her hospital, and found the number of providers recommending that younger women get routine screenings declined by more than half. Before the USPSTF released its guidelines, 56 percent recommended yearly screening for women 40-49. After the guidelines, that number fell to 20 percent. However, after the guidelines came out, 54 percent recommended one-on-one counseling about the risks and benefits of screening, as recommended by the USPSTF.
Finding cancer early
Another study also shared at the ARRS meeting, by Dr. Donna Plecha, chief of mammography at University Hospitals at Case Medical Center in Cleveland, found that cancers in young women caught by mammography were smaller and therefore likely easier to treat.
In her study, she reviewed records of 359 biopsies of women in their 40s who had screening mammograms at her hospital between 2008 and 2009. Of these women, about 15 percent had cancer -- cancers in an earlier and presumably more treatable stage, she said, according to a CNN report.
However, Dr. Virginia Moyer, the current chair of the USPSTF, said the study assumes catching some of the cancers earlier will actually save more lives, which might not be the case.
"The data that we have suggests that one in a thousand will benefit from mammograms in the 40-49 age," she told CNN. "There are whole lots of assumptions that are not supported by the data they presented."