Don't Alter Cancer Screening Plans Just Yet

The Register Guard (Eugene, OR), November 24, 2009 | Go to article overview

Don't Alter Cancer Screening Plans Just Yet


Byline: GUEST VIEWPOINT By Michael Milstein

I am a practicing radiologist in Eugene who has been involved with women's imaging locally for more than 15 years.

In the interests of women in this community, I feel compelled to discuss the recent recommendations of the U.S. Preventive Services Task Force concerning breast cancer screening.

Any radiologist who reads mammograms is used to controversy. It seems that every five years or so, questions concerning the benefits of screening mammography arise, creating controversy in the scientific and medical communities as well as in the lay press.

While this debate may be annoying to radiologists who feel as though they repeatedly must justify what they do, such controversies have had the beneficial effect of strengthening the scientific evidence and arguments supporting screening mammography.

Unfortunately, with controversy comes confusion and worry among those we are most interested in helping - women who undergo, or are considering, breast cancer screening with mammography. These women deserve guidance from the specialists in this field, namely radiologists.

So what is known about screening mammography? These pertinent facts come from many scientific studies that have examined thousands of women at many institutions in the United States and elsewhere for about the past 30 years:

Breast cancer screening with mammography significantly decreases mortality from breast cancer among women older than 40. The decrease occurs among women with and without risk factors for breast cancer.

The mortality rate from breast cancer has decreased markedly over the past 20 to 30 years (up to 30 percent), primarily due to screening mammography.

Screening mammography results in the earlier detection of breast cancer. Annual screening results in the detection of smaller cancers that require less-toxic therapy and that have a more favorable prognosis with a greater chance of cure.

The risk of breast cancer and the positive effects of screening gradually increase with age, but do not abruptly change between the arbitrary age ranges of 40 to 49 and older than 50.

These facts, gained from years of scientific study, have resulted in the current recommendations, which are supported by the American Cancer Society and the American College of Radiology. The recommendations call for annual screening mammography beginning at age 40 for most women.

The U.S. Preventive Services Task Force is a government-sponsored, independent panel of doctors and scientists funded and staffed by the Human Health Services Agency for Healthcare Quality. The task force's recommendations can be considered in determining Medicare coverage for preventive services. …

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Don't Alter Cancer Screening Plans Just Yet
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