News & Commentary

Does Mammography Screening Need to Start Earlier?

The 2009 recommendation by the U.S. Preventive Services Task Force that routine mammography screening begin at 50 did not put the issue to rest. In fact, it pushed it to the front lines of the debate about overtesting and overscreening, where it has remained.

Now comes a study in the journal Cancer reporting that more than two-thirds of breast cancer deaths occur in younger women who have either never had a mammogram or had them at intervals of two years or more.

The study, “A Failure Analysis of Invasive Breast Cancer,” published online in September, states, “To maximize mortality reduction and life-years gained, initiation of regular screening before age 50 years should be encouraged.”

The authors know they are throwing water on a grease fire: “In the presence of conflicting evidence, national recommendations for screening mammography have become a point of contention.”

They looked at 7,300 women diagnosed with breast cancer between 1990 and 1999 and tracked them until 2007.

Of the 609 deaths from breast cancer, 71% had not been screened or had been screened at intervals of two or more years. The median age of diagnosis for fatal cancer was 49. The median age for women who died of other causes was 72.


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