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An independent American public health organization recommended Tuesday that women start mammograms at the age of 40, rather than 50, and have them every two years.
Until now, between the ages of 40 and 50, women were invited to decide individually, according to their background and their preference, whether to have mammograms, intended to detect breast cancer.
From 40 years old to save 20% more lives
These new recommendations were proposed last year and submitted for public debate. They are now final and replace the previous ones, dating from 2016.
They are issued by the US Preventive Services Task Force (USPSTF), whose opinions are closely followed.
The change is notably justified by the increase in cases of cancer among younger women.
“More women in their 40s are getting breast cancer, with the rate increasing by 2% each year“, underlined in a press release the president of the Task Force, Wanda Nicholson.
According to this panel of experts, lowering the age to 40 could save 20% more lives.
And the new approach “has potentially even greater benefit for black women“, underlined Wanda Nicholson.
Greater benefit for black women
Black women have a 40% greater risk of dying from breast cancer than white women, indicates the USPSTF, estimating however that starting mammograms at age 40 will be “an important first step, but not enough” to reduce this gap.
The body is “urgently” calling for more research into how to reduce inequalities in care, as well as into women with dense breasts.
Having dense breasts, which is the case for almost half of women, increases the risk of breast cancer. But “more studies are needed” to improve their care, according to the organization, which has not issued a differentiated recommendation concerning them.
These recommendations concern women up to 74 years old. Beyond that, few studies exist on the benefits and risks of screenings and treatments, explains the organization.
Annual screening or every two years?
The panel also explains its choice to recommend screening every two years, and not annually. “Although annual screening may detect some cancers earlier, whether it would improve women’s health or increase the number of harms is unclear“, he said. These effects can be the false announcement of cancer, or the fact of receiving treatment which is not actually necessary, he quotes.
The USPSTF also notes that most health insurance plans already cover annual mammograms starting at age 40 for women who want them.
But the panel’s decision not to recommend annual screening was also criticized: it was described as “surprising” by Wendie Berg, professor in the department of radiology at the University of Pittsburgh, in an editorial published in the scientific journal Jama .
“There are more lives to be saved by screening younger women annually”, she wrote. She also regretted that women with dense breasts or breast cancer in their family are not recommended more frequent screenings.
Another organization, the American Cancer Society, recommends performing mammograms annually between the ages of 45 and 54.
In France, screening only begins at age 50
Nancy Chan, an oncologist at NYU Langone Hospital, said she was “happy” with the USPSTF’s proposed age change. “In fact, the majority of our patient population begins breast cancer screening at age 40.“, she told AFP. “But it is still important to see the recommendations reflect what we do in practice“.
The age of 50 is often the age used by official recommendations in other countries for the general population, such as in France.
The USPSTF specifies that its recommendations do not apply to people who have already had breast cancer or who have a very high risk of developing one (genetic factors), who must follow their doctor’s instructions.
Breast cancer is the second deadliest cancer for women in the United States behind lung cancer.