US women want to start mammogram screening at age 40

By David Liu

A new survey of 1,136 women by USA TODAY/Gallup Poll suggests that American women like to receive Mammogram screening more often than the new guidelines set by the U.S. Preventive Service Task Force.

The task force recommends that women should begin biennial mammogram screening for breast cancer at age 50 instead of 40 as recommended by the old guidelines.

Georgetown University Medical Center funded by the US government reported a new review in the Nov 17, 2009 journal Annals of Internal Medicine that suggests "biennial (every two years) screening of average risk women between the ages of 50 and 74 achieves most of the benefits of annual screening, but with less harm."

The review shows that mammogram screening every other year delivers an average of 81 percent of annual screening results, but with only half the number of false-positives.

Mammogram screening every other year from ages 50 to 69 reduces breast cancer mortality by 16.5 percent over a life time, compared to no screening whatsoever. Screening beginning at the age of 40 reduces the mortality rate by 19.5 percent, or one woman in every 1000, compared to screening starting at age 50. But false-positives, unnecessary biopsies and anxiety increase.

Of the surveyed, 76 percent of women said they disagreed or strongly disagreed with the new recommendations. Of women aged 35 to 49, 84 percent said they planned to receive mammograms before age 50.

The task force did not say that women under 50 should not or do not have to undergo mammogram screening, but suggested that women in their 40s talk to their physicians about the benefits and risks of screening, which include false alarms and unnecessary treatment and radiation-induced breast cancer risk.

Media reports say that as many as 55 millions of mammography exams are performed each year in the United States and about 5.5 millions show abnormal mammogram results.

Recent studies have found that mammograms increase the diagnosis rate, but it does not reduce the mortality, particularly in those with advanced breast cancer.

The survey did not mean to learn how many women actually know the risk of radiation-based mammogram screening. X-ray or radiation is recognized by the US government as a cancer causing agent or carcinogen.

John W. Gofman, M.D. Ph.D. a well known nuclear physician and scientist who passed away a few years ago, addressed the risk of mammogram screening in his 1996 book titled "Preventing Breast cancer".

Dr. Gofman said each exam requires two views of each breast and each view needs 0.1 rad of x-ray. That means each breast will receive 0.2 rad.

He calculated the risk and found that of women aged 30 to 34 who receive five exams, about 5 out of 1000 will acquire radiation-induced breast cancer. Of women aged 35 to 49 who receive 10 exams, slightly more than 5 out of 1000 will get radiation-induced breast cancer. Of women aged 50 to 64 who get 15 exams, about 8 out of 1000 will develop radiation-induced breast cancer.

Breast cancer induced by all risk factors is found in about 175,000 women each year in the United States and the disease and its complications kill about 45,000 each year.