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Mammogram Rates Declined 3 Years After Unadopted Task Force Recommendations

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A Harvard study found that fewer women ages 40 to 64 got screening mammograms 3 years after the U.S. Preventive Services Task Force (USPSTF) recommended that screening mammograms start at age 50 instead of 40 and that screening mammograms be done every 2 years instead of every year.

The research was published online on Feb. 9, 2015 by the Journal of Clinical Oncology. Read the abstract of “Mammography Rates 3 Years After the 2009 US Preventive Services Task Force Guidelines Changes.”

The Harvard researchers looked at mammography trends among 5.5 million women ages 40 to 64 who had health insurance through a large national company. The researchers used 2005 to 2009 mammography trends to predict 2012 mammography rates. They then compared the predicted mammography rate to the actual rate to see if there were a difference.

Compared to the predicted rate, actual mammogram rates were:

  • 9.9% lower for women ages 40 to 49; decreases were lowest among Black women (2.3%) and highest among Asian women (17.4%)

Annual mammogram rates were 6.1% lower for women ages 50 to 64.

The researchers also looked to see if the rates of biennial mammograms (getting a mammogram every 2 years) went down. Compared to the predicted rate, actual biennial mammogram rates were:

  • 9.0% lower in women ages 40 to 49; this drop was about the same for white, Hispanic, and Asian women, while Black women in this age group had no real drop in biennial mammogram rates
  • 6.2% lower in women ages 50 to 64; again, this drop was about the same for white, Hispanic, and Asian women, while
  • Black women in this age group had no real drop in biennial mammogram rates

The value of annual screening mammograms was questioned in November 2009 when the USPSTF recommended:

  • Screening mammograms for women at average risk of breast cancer should start at age 50, rather than at 40 as current guidelines recommend.
  • Only women at very high risk of breast cancer should get screening mammograms when they're younger than 50.
  • Screening mammograms should be done every other year instead of every year, as current guidelines recommend.
  • There's not enough evidence to support teaching and encouraging breast self-exam.
  • There's not enough evidence to encourage women older than 75 to get mammograms.

The recommended changes were very controversial and were NOT adopted.

If you're 40 or older and have an average risk of breast cancer, yearly screening mammograms should be part of your healthcare. If your breast cancer risk is higher than average, you may want to talk to your doctor about a more aggressive breast cancer screening plan that makes the most sense for your particular situation.

The Mayo Clinic, the American Medical Association, the American College of Obstetricians and Gynecologists, the American College of Radiology, the American Cancer Society, and the National Cancer Institute all recommend that screening mammograms should start at age 40.

There's only one of you and you deserve the best care possible. Don't let any obstacles get in the way of your regular screening mammograms.

  • If you're worried about cost, talk to your doctor, a local hospital social worker, or staff members at a mammogram center. Ask about free programs in your area.
  • If you're having problems scheduling a mammogram, call the National Cancer Institute (800-4-CANCER) or the American College of Radiology (800-227-5463) to find certified mammogram providers near you.
  • If you find mammograms painful, ask the mammography center staff members how the experience can be as easy and as comfortable as possible for you.

For more information on mammograms, visit the pages on mammograms.

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