USPSTF recommends breast cancer screening every other year starting at age 40
USA: The U.S. Preventive Services Task Force (UPSTF) has released a draft recommendation statement for breast cancer screening.
In its updated recommendation, the task force recommends that all women aged 40 to 74 years should be screened for breast cancer every other year to reduce their risk of dying from this disease (B grade recommendation).
The recommendation does not apply to those with a history of breast cancer, those who had a lesion on previous biopsies and those with a very high risk for breast cancer because of a history of high-dose radiation therapy to their chest at a young age or certain genetic markers.
In its draft recommendation, the task force also urgently called for more research to build on their existing recommendation and help all women live longer and healthier lives. They needed to know how to best address the health disparities across screening and treatment experienced by Hispanic, Black, Latina, Pacific Islander, Asian, Native American, and Alaska Native women.
The recommendation is an update to the 2016 recommendation of the task force, which recommended that women in their 40s should make individual decisions about when to start screening.
Although no trials compared annual versus biennial screening, when considering lives saved against harms like unnecessary follow-up and treatment, the task force concluded that women benefit more when screening is done every other year.
"New and more inclusive science about breast cancer in people younger than 50 has enabled us to expand our prior recommendation and encourage all women to get screened in their 40s," the authors wrote in their draft. "We have long known that screening for breast cancer saves lives, and the science now supports all women getting screened every other year, starting at age 40."
The USPSTF also released two I draft recommendation statements. The task force concluded that there is not yet enough evidence to determine:
- the benefits and harms of screening in women aged older than 75 years; and
- if women with dense breasts should have additional screening with breast ultrasound or MRI.
The document stated, "Nearly half of all women have dense breasts, which raises their breast cancer risk and implies that mammograms do not work as well for them." "These women deserve to know whether and how additional screening might help them stay healthy."
"Unfortunately, there is not yet enough evidence for the Task Force to recommend for or against additional screening with breast ultrasound or MRI," the task force wrote.
They urgently called for more research on whether and how additional screening might help women with dense breasts find cancers earlier.
According to the USPSTF, Black women are 40% more likely to die from breast cancer than white women.
"Breast cancer screening in Black women at age 40 is an important first step, but is not enough to improve these inequities," they wrote.
"It’s important that healthcare professionals involve patients in a conversation on how best to support them to ensure equitable follow-up after screening and timely and effective treatment of breast cancer."
Reference:
Draft recommendation statement. https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/breast-cancer-screening-adults. Published May 9, 2023. Accessed May 4, 2023.
