Adding to the controversy surrounding the 2009 USPSTF's (U.S. Preventive Services Task Force) mammography guidelines is a study published in February's issue of the Journal of Roentgenology which claims widespread adherence to the recommendations would increase the number of deaths from breast cancer. The guidelines, which recommended that women begin receiving screening mammograms at age 50 rather than 40, and biennially as opposed to yearly, would result in 65,000 fewer deaths from breast cancer among the 20 million U.S. women currently ages 30-39.
The study's authors reexamined evidence used by the task force including modeling of different screening scenarios done under the Cancer Intervention and Surveillance Modeling Network project. Mortality reduction between two hypothetical cohorts of women just reaching screening age were compared, with one group following USPSTF's 2009 guidelines and the other following the American Cancer Society's recommendation of annual screening for those 40 and older. Averaging all the models together, annual screening mammography for women ages 40-84 decreased mortality 39.6% as compared with a 23.2% reduction from USPSTF-recommended screening frequency.
The authors also found that potential "harms" identified by the task force, including patient anxiety, radiation exposure and pain during procedure were overstated. For women ages 40-49, the harm from a screening mammogram includes the risk of a recall for diagnostic workup every 12 years, a negative biopsy every 149 years and a fatal radiation-induced breast cancer every 76,000-97,000 years.
Pointing to the findings of their study, the authors contend the USPSTF guidelines have negatively impacted efforts to improve screening rates, having "dissuaded some women from undergoing mammography," which is an opinion that has been voiced by many since release of the guidelines.