The latest recommendation from the U.S. Preventive Services Task Force is that all women ages 40 to 74 get a mammogram every other year. A previous recommendation said screening should start at age 50.
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Heather Charles/Tribune News Service via Getty Images
New research makes the case for educating women in their 40s, caught up in the decades-long debate over whether to screen for breast cancer with mammograms, about the risks and benefits of the test.
A study published Monday in the American Journal of Medicine found that among a nationally representative sample of U.S. women aged 39 to 49 who were informed about the benefits and risks of mammograms, those who chose to wait until age 50 to get screened were more likely to do so. There are more than twice as many people. Annals of Internal Medicine established.
By the time most women reach midlife, they’ve been exposed to the widely disseminated message that screening mammograms save lives. But many people remain unaware of the cost of routine screening in their 40s—false-positive results, unnecessary biopsies, anxiety, and debilitating treatments for tumors that can do no harm if left unchecked.
“In an ideal world, all women would have access to this information and then have their doctors answer their further questions and develop a screening plan that’s right for them based on their preferences, values, and risk levels,” says social media psychologist Lau Laura Scherer is the study’s lead author and a research associate professor at the University of Colorado School of Medicine.
Of the 495 women interviewed, only 8% initially said they wanted to wait until age 50 to get a mammogram. After researchers informed women of the benefits and harms, 18 percent said they would wait until age 50.
‘We are dishonest’
Research shows that knowing the disadvantages of mammograms doesn’t stop women from wanting to get tested at some point.
Nearly half of study participants were surprised by the benefits and harms of mammograms. More than a quarter said they learned something different from the study about overdiagnosis than what their doctors told them.
“We’re being dishonest with people,” said Dr. Laura Esserman, a breast cancer surgeon and director of the Breast Care Center at the University of California, San Francisco, who was not involved in the study.
“I think most people are completely unaware of the risks associated with screening because we’ve had 30, 40 years of public health campaigns: Go out and get your mammogram and everything will be fine,” she told NPR said during the interview.
Esserman sees women diagnosed with slow-growing tumors that she believes will likely never harm them. Additionally, mammograms can give women a false sense of security, she said, just like Olivia Munn did.
The 44-year-old actress had a clean mammogram that came back negative for the cancer gene shortly before doctors calculated her lifetime breast cancer risk score, setting off alarms that led to her undergoing surgery for the rapidly metastatic, aggressive breast cancer Treatment.
Develop a personal screening plan
Esserman advocates for a personalized approach to breast cancer screening, like the one that led to Moon’s diagnosis. In 2016, she launched the WISDOM study, which aims to tailor screening to women’s risk and, in her words, “test smarter, not test more.”
The National Cancer Institute estimates that more than 300,000 women in the United States will be diagnosed with breast cancer this year and 42,250 will die. Incidence rates rise by approximately 1% per year, while mortality rates decrease by slightly more than 1% per year.
For the past 28 years, the influential U.S. Preventive Services Task Force’s recommendations on when women should start getting mammograms have been inconsistent.
From 1996 to 2002, an independent group of volunteer medical experts who helped guide doctors, insurance companies and policymakers said women should start getting screened at age 50. Get screened once a year. In 2009, it said women in their 40s should decide whether to have a mammogram based on their health history and personal preferences.
The new research was conducted in 2022 and the task force guidance calls on women in their 40s to make personal decisions.
New guide
In 2024, the group again said that all women between the ages of 40 and 74 should get a mammogram every other year. The push for early screening comes amid rising rates of breast cancer among young women and models showing that screening saves lives, especially among black women.
An editorial accompanying the new study highlights the need for mammography education and the value of shared decision-making between clinicians and patients.
“To make informed decisions, overdiagnosed Harm—defined as a diagnosis of asymptomatic cancer that does not harm the patient in the future—must be communicated.
