There’s been a lot of news about when women should have mammograms. Now a new large study suggests that many postmenopausal women can actually have mammography screenings every two years without having health consequences.
Researchers from the University of California, San Francisco collected data on 2,993 older women who had breast cancer as well as 137,949 older women without breast cancer. All of the women were between the ages of 66 and 89. These women had mammograms at facilities that took part in a data linkage between the Breast Cancer Surveillance Consortium and Medicare claims. The researchers also reviewed data on the participants who received false-positive reports. This information is important because women who receive these reports usually have more tests to determine if they have cancer. These additional tests can lead to unnecessary procedures, additional costs, time away from daily responsibilities and heightened anxiety.
The researchers found that women in this age group who have biennial mammography screenings actually have a similar risk of advanced-stage disease as women who had annual screenings. These women also had a lower cumulative risk of having a false-positive finding than annual screeners. What was the difference in false positives? "After 10 years of screening, almost half, or 48 percent, of the women who were screened every year had at least one false-positive," Dr. Dejana Braithwaite, an assistant professor of cancer epidemiology at the UCSF’s Helen Diller Family Comprehensive Cancer Center and the study’s lead researcher, told HealthDay News. "Among those screened every two years, 29 percent had at least one false-positive after 10 years."
So how significant is the cost of breast cancer screenings? Another recent study found that the cost to Medicare of breast cancer screening procedures (which includes the screening and the workup) actually tops $1 billion annually. The annual total screening-related expenditures for women who are 75 years of age and older exceeds $10 million.
Some experts believe federal funds need to be used to identify environmental causes of breast cancer. The Interagency Breast Cancer and Environmental Research Coordinating Committee (which is a group of scientists, government officials and patient advocates) recommends the following:
- Prioritize prevention. Increased funding should be used to focus on reducing or eliminating harmful environmental exposures that can lead to breast cancer. The group also recommends targeting social and lifestyle factors that are linked to this type of cancer.
- Transform how research is conducted through increased investment to explore new avenues as well as environmental factors on breast development.
- Intensify the study of chemical and physical factors that may influence the risk of developing and surviving breast cancer.
- Plan strategically across federal agencies in order to foster collaboration on looking at breast cancer and the environment.
- Engage public stakeholders to provide feedback and disseminate research findings.
- Train researchers so that they can work across disciplines in order to accelerate research on breast cancer and the environment.
- Translate and communicate science to society so that people can reduce exposures that increase the risk of the disease as well as adopt behaviors that may help in prevention.
So what should you do with this information? First of all, if you have a family history of breast cancer or who feel uncomfortable with having a screening every other year, work with your health care provider to schedule an annual mammogram. However, if you don’t have this type of history or are comfortable with the idea of having a mammogram every other year, confer with your doctor about that possibility. Also, start learning about the environmental and lifestyle factors that can increase your risk of breast cancer and take the appropriate steps.
Primary Sources for This Sharepost:
Braithwaite, D., et al. (2013). Screening outcomes in older US women undergoing multiple mammograms in community practice: Does interval, age or comorbidity score affect tumor characteristics or false positive rates? Journal of the National Cancer Institute.
Gross, C. P., et al. (2013). The cost of breast cancer screening in the Medicare population. JAMA Internal medicine.
HealthDay News. (2013). For older women, mammograms every 2 years found as good as annual test. MedlinePlus.
Interagency Breast Cancer and Environmental Research Coordinating Committee. (2013). Breast cancer and the environment: Prioritizing prevention. National Institute of Environmental health Sciences.