Published on
Updated
Reading 3 mins.
Based on new evidence, an American public health prevention organization issued a new recommendation on May 9: women should start mammograms at the age of 40, and no longer 50 as previously.
Planning your first mammogram at age 40 rather than 50 could save thousands of lives. This is the notice published on May 9 by the US Preventive Services Task Force, an American working group on prevention, while the rate of cancer continues to grow.
Is lowering the screening age enough?
The working group justifies this recommendation by new scientific evidence associated with a worrying trend: in fact, the rate of breast cancer among women in their forties in the United States increased by 2% per year on average between 2015 and 2019. the age of screening at 40 could save 19% more lives according to their announcement.
An offensive recommendation, but not necessarily sufficient for the country’s experts interviewed by NBC, such as Dr. Melissa Durand, associate professor in the department of radiology and biomedical imaging at Yale School of Medicine.
“They are a step in the right direction, but I worry about the annual periodicity. We will miss cancers if we screen every two years and not every year”
Other medical groups, such as the American cancer society or the American college of radiology already recommend screenings from the age of 40, and at an annual frequency. Dr. Phoebe Freer, head of the breast imaging department and cancer specialist and also quoted by NBC, believes that screening every two years will not do much to reduce disparities in breast cancer outcomes. We had indeed written a short time ago, in the United States, black women are 40% more likely to die of breast cancer than white women. People with dense breasts should also be screened every year, according to specialists. Lowering the age is therefore only part of the answer.
The US Preventive Services Task Force recalls, however, that these new recommendations are not yet final, being first subject to a period of public debate.
In France, screening recommended at age 50 only
In France, screening is free and organized every two years for women aged 50 to 74, according to Health Insurance, except at particular risk, or apparent symptom which invites consultation earlier.
An essential measure for Doctor Coussy Florence, gynecologist and oncologist specializing in senology at the Institut Curie, contacted by Doctissimo.
“Clearly, this screening is effective, because it improves the survival of women and allows for less invasive lesions since they are detected earlier. However, if these new recommendations in the United States, take into account age, c is because there, as here, as everywhere in the world, the rate of cancers before the age of 50 is not negligible: according to the latest figures from the INCa, these represent 20% of breast cancers, so even that these women are not concerned by organized screening.”
Screening before the age of 50, however, raises many questions, as the expert continues:
“Should all women be screened the same way regardless of their age and risk factors? The answer is no, of course. But the ideal would be to be able to model the individual risk of each woman by because of their background, individual risks, genetics, breast density, etc. And to adapt screening and even its frequency.”
A new trial conducted in Europe to determine the best screening
These questions, which have not yet been optimally resolved, could however find an answer closer to women. As Dr. Coussy reminds us, a European trial called MyPeBS (My Personal Breast Screening) currently underway intends to study everything that makes screening personal: mammography alone, mammography + MRI, frequency of screening… and this according to of the individual risk of each woman, from 40 to 70 years.
“It will also give a robust answer for screening patients over 40 in Europe” she argues. Before highlighting another problem to be solved in order to achieve this ideal screening: “In France, less than 50% of women will be screened, so we will also have to do a lot of communication work to be able to improve the care of women.”
As a reminder, in France as in the United States, breast cancer is the most common and therefore the most deadly, ahead of colon, rectum and lung cancer, with some 59,000 new diagnoses each year and more than 12,000 deaths.