A new study being presented next week at the Radiological Society of North America (RSNA) shows that women prefer to receive an annual mammogram, as opposed to one every two years, as current guidelines recommend.
In a statement, study author Ghizlane Bouzghar, chief radiology resident at Einstein Medical Center in Philadelphia, Pa., says, “Women understand that yearly mammograms have been shown to save lives and do not consider previously reported ‘harms’ to be as important as getting screened.”
Bouzghar and his fellow researchers surveyed 731 women receiving screening and diagnostic mammograms at Einstein Medical Center over a three-month period earlier this year, asking whether abnormal results and biopsies cause them emotional harm, whether screening every two years causes more or less anxiety than annual screening, and what their preference was in terms of screening frequency. Seventy-one percent of these women said they preferred getting screened every year.
In 2009, the U.S. Preventive Services Task Force (USPTF) changed the recommendation regarding mammogram screenings for women from annually to once every two years because of risk of diagnosis and treatment of noninvasive and invasive cancers that would otherwise not have become a threat to women’s health, as well as unnecessary biopsies and stress resulting from the potential from false-positive results from these screens. The USPTF reaffirmed these recommendations in 2016.
A systemic review of the harms associated with breast cancer screening mammography from the USPTF found that there is 10-year, cumulative false-positive rate of 61 percent with annual screening, but that false positive rate drops to 42 percent when screening occurs every two years.
The American Cancer Society, however, presently recommends annual screening for average-risk women between the ages of 40 and 54, and biennial screening with the option to continue annual screening for women ages 55 and older.
This past June, the American College of Obstetricians and Gynecologists (ACOG) issued a revision of its own breast cancer screening guidance for average-risk women, emphasizing that shared decision-making between patients and providers is most critical for determining a patient’s need for screening mammography.
Per ACOG’s updated recommendations, women with an average risk of breast cancer should be offered screening mammography starting at age 40. If they have not initiated screening in their 40s, then they should begin screening mammography by no later than age 50.
ACOG recommends that women and their ob-gyns engage in a dialogue that includes discussion of the woman’s health history; the benefits and harms of screening; and the woman’s concerns, priorities, values, and preferences about the potential benefits and harms of screening. Based on this conversation, the medical organization says, average-risk women should then determine whether they wish to be screened every one or two years. Screening mammography should continue until a woman is 75 years old, at which point shared decision making should again inform her decisions regarding continued screening.
In a statement made following the issuance of ACOG’s revised breast cancer screening guidelines, Christopher M. Zahn, M.D., and the vice president of practice activities for ACOG, said, ““Our new guidance considers each individual patient and her values. Given the range of current recommendations, we have moved toward encouraging obstetrician–gynecologists to help their patients make personal screening choices from a range of reasonable options.”
Breast cancer is the most commonly diagnosed cancer in women and the second leading cause of cancer death in American women.
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