Mammography Screening Guidelines May Be Misleading

Several Cancer Intervention and Surveillance Modeling Network (CISNET) models have shown that receiving annual mammography screenings beginning at age 40 years is associated with the greatest reduction in breast-cancer–related mortality, according to a recent study.

Existing recommendations from multiple national health care organizations include annual screening from age 40 to 84 years; a hybrid recommendation of annual screening from age 45 to 54 years and then biennial screening from age 55 to 79 years; and biennial screening from age 50 to 74 years. However, the benefits and risks of each recommendation was previously unknown.
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In their study, the researchers assessed the efficacy of each recommendation via 6 CISNET models. The mean values of each model were used to compare the benefits and risks associated with each recommendation.

Results indicated that annual screening from age 40 to 84 years was associated with the greatest mean reduction in mortality (39.6%), compared with the hybrid recommendation (30.8%) and the recommendation of starting biennial screening at age 50 years (23.2%).

In this particular cohort, starting annual screening at age 40 years would result in the greatest total number of screening mammograms, benign recalls, and benign biopsies performed over the course of screening, compared to the other 2 recommendations.

“CISNET models demonstrate that the greatest mortality reduction is achieved with annual screening of women starting at age 40 years,” the researchers concluded.

—Christina Vogt

Reference:

Kagan Arleo E, Hendrick RE, Helvie MA, Sickles EA. Comparison of recommendations for screening mammography using CISNET models [Published online August 21, 2017]. Cancer. doi:10.1002/cncr.30842.