A comprehensive analysis by Monticciolo and colleagues, utilizing the Cancer Intervention and Surveillance Modeling Network (CISNET) 2023 median estimates, underscores the life-saving potential of initiating annual breast cancer screenings at age 40. This study, pivotal in the ongoing debate over breast cancer screening guidelines, compared the outcomes of various screening scenarios, including the previous U.S. Preventive Services Task Force (USPSTF) recommendation of biennial screenings for women aged 50-74. The findings advocate for annual screenings from ages 40 to 74, highlighting significant benefits such as mortality reduction and increased life years, while also considering the risks of benign biopsies and recall rates.
The American College of Radiology (ACR) and Society of Breast Imaging (SBI) align with this recommendation, emphasizing early detection’s role in improving survival rates and reducing the need for extensive treatment. Notably, one in six breast cancers occurs in women in their 40s, reinforcing the importance of starting annual mammograms at this age[.
However, disparities in breast cancer screening and outcomes persist among different racial and ethnic groups in the U.S. Black women, despite having a higher screening rate, face a 39% higher breast cancer mortality rate compared to their white counterparts. In contrast, American Indian and Alaska Native women have the lowest screening rates, which may be attributed to access barriers. Hispanic/Latina women, while having similar screening rates to white women, are diagnosed with more advanced breast cancers, pointing to delays in follow-up care after abnormal mammograms.
Efforts to address these disparities include population screening for breast cancer risk in primary care settings, which has shown promise in increasing mammography use among medically underserved racial and ethnic minority groups. This approach, emphasizing individualized risk estimates, could play a crucial role in mitigating breast cancer mortality disparities.
CISNET’s role in evaluating the impact of cancer control interventions through statistical and simulation modeling is invaluable for informing optimal cancer screening strategies and has been instrumental in shaping national screening guidelines.
“Annual breast cancer screening starting at age 40 saves lives” by Amerigo Allegretto on the Aunt Minnie website (February 20, 2024)
