In a controversial shift, a leading US medical association on October 20 urged women to wait until the age of 45 before getting an annual mammogram to screen for breast cancer. The American Cancer Society previously recommended women be screened each year from age 40, but has changed its advice because evidence failed to show enough lives are being saved.
And while younger women are being advised to start later, women over 55 are now urged to switch to getting mammograms every two years, instead of annually.
"Since the last American Cancer Society (ACS) breast cancer screening update for average-risk women was published in 2003, new evidence has accumulated from long-term follow-up of randomised controlled trials and observational studies," said the guidelines, published in the Journal of the American Medical Association (JAMA). Women should still have the opportunity to begin annual screenings at 40 if they choose, the guidelines noted.
Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York, described the new guidelines as "disappointing." "Although the recommendations are based on scientific studies, most of the studies only look at survival as the only important outcome," Bernik said.
"They fail to address the fact that women with smaller tumors often need less treatment." Breast cancer is the most common form of cancer in women world-wide. It is also the second deadliest form of the disease in women, after lung cancer. More than 40,000 women in the United States will die of breast cancer this year, according to background information in the article.
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