Mammo Rates Unchanged Despite Controversial Guidelines04/19/13
FRIDAY, April 19 (HealthDay News) -- More than three years after
controversial new guidelines rejected routine annual mammograms for
most women, women in all age groups continue to get yearly
screenings, a new survey shows.
In fact, mammogram rates actually increased overall, from 51.9
percent in 2008 to 53.6 percent in 2011, even though the slight
rise was not considered statistically significant, according to the
researchers from Brigham and Women's Hospital and Harvard Medical
"There have been no significant changes in the rate of screening mammograms among any age group, but in particular among women under age 50," said the study leader, Dr. Lydia Pace, a global women's health fellow in the division of women's health at Brigham and Women's.
While the study did not look at the reasons for continued
screening, the researchers speculated that conflicting
recommendations from various professional organizations may play a
In 2009, the U.S. Preventive Services Task Force, an independent
panel of experts, issued new guidelines that said women younger
than 50 don't need routine annual mammograms and those 50 to 74
could get screened every two years. Before that, the recommendation
was that all women aged 40 and older get mammograms every one to
The recommendations ignited much controversy and renewed debate
about whether delayed screening would increase breast cancer
mortality. Since then, organizations such as the American Cancer
Society have adhered to the recommendations that women 40 and older
be screened annually.
To see what effect the new task force recommendations have had,
the researchers analyzed data from almost 28,000 women over a
six-year period -- before and after the new task force
The women were responding to the National Health Interview
Survey in 2005, 2008 and 2011, and were asked how often they got a
mammogram for screening purposes.
Across the ages, there was no decline in screenings, the
Among women 40 to 49, the rates rose slightly, from 46.1 percent
in 2008 to 47.5 percent in 2011. Among women aged 50 to 74, the
rates also rose, from 57.2 percent in 2008 to 59.1 percent in
The study, supported by Brigham and Women's Hospital, is
published in the April 19 online edition of the journal
Pace said conflicting recommendations from different
organizations could have generated much confusion among both
doctors and patients.
She added, "Another possibility would be that some providers and
patients would simply be in disagreement [with the task force
In the 2009 recommendations, the task force said women 40 to 49
should discuss the pros and cons with their doctor, then decide
whether to get screened. The task force took into account the lower
incidence of breast cancer in younger women, as well as the
downsides of screening, such as false positives, in which cancer is
suspected but not found. False positives can lead to unnecessary
testing, expense and emotional strain, experts say.
But even if a woman's doctor advises reducing the number of
mammograms or waiting until age 50, "patients can self-refer for
mammography," Pace said.
"It's an emotionally charged decision for women and doctors as well," she added.
"I'm not surprised by this," said Dr. Joanne Mortimer, co-director of the breast cancer program at the City of Hope Comprehensive Cancer Center, who reviewed the findings.
She, too, speculated there could be many reasons behind the
findings. "It takes years for doctors to change their practice,"
she said, adding that many doctors may still not be comfortable
with the new guidelines.
Doctors could also be reluctant to suggest delayed screenings
for younger women or expanding the interval between tests for older
women, Mortimer added, because of fears of possible lawsuits if a
cancer goes unnoticed.
Insurers have not looked to the task force recommendations as a
reason to drop coverage for mammograms, both Mortimer and Pace
And screening mammograms every one to two years are due to be
covered, without expense, as a preventive care service under the
Affordable Care Act for women over 40.
The task force aims to review each medical topic every five
years, according to a spokesperson. By that schedule, screening
mammogram recommendations would be due for a re-evaluation in
To learn more about mammograms, visit the
American Cancer Society.
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