Starting Screening Mammography at Age 40 Leads to Greatest Mortality Benefit

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Routine screening mammography is an effective means of reducing cancer deaths.
Routine screening mammography is an effective means of reducing cancer deaths.

Cancer Intervention and Surveillance Modeling Network (CISNET) models show that women who begin annual breast cancer screenings at age 40 years may experience the greatest mortality benefit and avert the most cases of breast cancer, according to a study published in Cancer.

Routine screening mammography is a highly effective method to reduce breast cancer deaths. The 3 most commonly adhered to protocols for annual screening mammography recommend (1) annual screenings at ages 40 to 84 years, (2) annual screenings at ages 45 to 54 years then biennial screenings at ages 55 to 79 years, or (3) biennial screenings at ages 50 to 74 years. A recent CISNET analysis assessed the implications of only one of these recommendations.

For this study, 6 different CISNET models were used to determine the quantitative estimates of benefits and risks of the 3 screening recommendations.

Results of the CISNET analysis demonstrated that mean reductions in mortality were 39.6% with annual screening at ages 40 to 84 years, 30.8% with a hybrid of annual screenings at ages 45 to 54 years then biennial screening, and 23.2% for biennial screenings at ages 50 to 74 years.

The study estimates that a single cohort of US women who start annual screenings at age 40 years would avert 29,369 deaths compared with 22,829 deaths averted with the hybrid recommendation. Women who receive screenings biennially would avert 17,153 and 15,599 deaths based on 2009 and 2016 CISNET estimates, respectively. 

The authors conclude that “individual women should continue to have the choice to reduce their risk of dying from breast cancer as much as possible, and as CISNET models show, annual mammography starting at age 40 years is the best way to do so.”

Reference

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

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