Medical Experts Disagree on Mammogram Screening Recommendations

At what age should women start getting breast cancer mammogram screenings? How frequently should screenings be scheduled?

In a paper published in April, 2017 in JAMA Internal Medicine, (1) physician recommendations were reviewed. The bottom line: medical experts disagree on the answers to these questions. More accurately, they continue to disagree; indeed, their recommendations vary considerably.

American Cancer Society: 12.4% of All American-Born Women Will Develop Breast Cancer

The issue is one of great concern: statistics provided by the American Cancer Society (ACS) indicate that about 12.4% of women born in the US will actually develop breast cancer “at some time during their lives.” (2) The ACS’s 2015 guidelines (3) recommend that women who have an “average risk of breast cancer” have the option to start screening every year. (Women who have a higher than average risk include those with a personal or family history of breast cancer, those with a genetic mutation more likely to develop cancer, and those who have had chest radiation therapy before the age of 30). The ACS also recommends that women of average risk between the ages of 45 – 54 get yearly mammograms.

Recommendations of Primary Care Physicians and Gynecologists

There is disagreement, however, among other medical groups: The American Congress of Obstetricians and Gynecologists’ guidelines (4) indicate yearly mammograms for all women starting at the age of 40. The 2016 guidelines of The US Preventive Services Task Force (5, 6) recommend that women aged 50 to 74 get mammograms every other year.

Yet, the majority of the 887 primary care physicians and gynecologists surveyed for the JAMA paper still recommend screenings for all women:

  • 81% recommended screenings for women 40 – 44
  • 88% recommended screenings for women 45 – 49
  • 67% recommended screenings for women 75 and older

Finally, the recommended frequency of screenings for those doctors who recommended them:

  • 62.% - annual screenings for women 40 – 44
  • 66.7% - annual screenings for women 45 – 49
  • 52.3% - annual screenings for women 75 and older

While medical experts disagree on specifics pertaining to scheduling breast cancer screenings, there is agreement on one issue: discussions between patient and physician should start at the age of 40 for all women.

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