New medical guidelines say that women in their 40s should decide for themselves whether they need regular mammograms to screen for breast cancer. The guidelines, which are still in draft form, were released by the U.S. Preventive Services Task Force (USPSTF), an independent panel of medical experts who recommend health screening procedures based on the latest scientific evidence.
USPSTF doesn’t make decisions about which procedures are covered by health insurance, but its guidelines are scrutinized by the medical community. In 2009, USPSTF faced criticism after raising its recommended age for regular mammograms to 50. The organization’s new guidelines still recommend a mammogram every two years for women ages 50 to 74.
Revising mammogram guidelines for women in their 40s may prove to be less controversial. The American Cancer Society and the American College of Obstetricians and Gynecologists both recommend annual screenings beginning at age 40; however, the American Cancer Society is currently reviewing its own mammography recommendations based on current scientific evidence.
Let women decide about screening?
Getting healthcare providers and their patients to understand the latest USPSTF guidelines may be more challenging. As Kristen Bibbins-Domingo, MD, PhD, and USPSTF vice chair explains, the group’s 2009 guidelines were “widely misinterpreted”. To be clear, USPTF isn’t against mammograms for women in their 40s. Rather, the organization wants women to make their own decisions about screening.
The scientific evidence, Dr. Bibbins-Domingo explains, includes the risk that an unnecessary mammogram will result in a false-positive test, and subject the patient to unnecessary follow-up tests and medical procedures. More serious harm occurs when women who are “overdiagnosed” with a non-threatening type of cancer undergo surgery and cancer therapy that diminishes their quality of life.
What are your thoughts?
As a healthcare provider, what do you think of the new USPSTF mammography guidelines for women in their 40s? Are you ready to explain what they mean – and then leave the choice up to her?