The study comparing various screening scenarios, including annual screening at ages 40 to 79, revealed that this particular age range resulted in the greatest reduction in mortality. According to Debra L. Monticciolo, MD, and colleagues from Dartmouth-Hitchcock Medical Center, mortality was reduced by 41.7% with annual screening starting at age 40 and continuing up to age 79. This was a significant improvement compared to other scenarios such as biennial screening at ages 50-74 reducing mortality by 25.4%, biennial screening at ages 40-74 reducing mortality by 30%, and annual screening at ages 40-74 reducing mortality by 37%.
Annual screening at ages 40-79 not only averted the most breast cancer deaths (11.5 per 1,000 screened) but also gained the most life-years (230 per 1,000 screened) in comparison to other screening scenarios. While false-positive screening results and benign biopsies were higher with annual screening at ages 40-79, the study’s authors suggested that these risks are manageable on a per-examination basis. Therefore, the benefits of annual screening in this age range outweigh the risks.
The study’s findings challenge the current guidelines from the U.S. Preventive Services Task Force (USPSTF), which recommend biennial screening from ages 40-74. Monticciolo and her team concluded that changing the recommendation to annual screening up to age 79 would significantly improve mortality reduction for all U.S. women. They emphasized that the goal of any cancer screening program is to prevent untimely cancer deaths, and annual breast cancer screening from 40 to 79 years of age and beyond is the most effective way to achieve this goal.
In an accompanying editorial, Bonnie N. Joe, MD, PhD, highlighted the importance of reducing healthcare disparities in breast cancer screening. She expressed disappointment in the USPSTF’s decision to stick with a biennial screening interval, especially considering the potential impact on reducing disparities, particularly among younger and Black individuals. The study’s authors also noted that annual screening up to 79 years of age showed the highest breast cancer mortality reduction, breast cancer deaths averted, and life-years gained for Black women compared to other screening scenarios.
Despite the promising findings of the study, the authors acknowledged certain limitations. For instance, the CISNET model estimates for 2016 and 2023 only extended up to ages 74 and 79, respectively. As a result, they could only approximate the current recommendations of annual screening starting at age 40 and extending beyond age 79 by organizations such as the American College of Radiology, Society of Breast Imaging, and National Comprehensive Cancer Network.
The study’s results provide compelling evidence in support of annual breast cancer screening at ages 40 to 79 as the most effective strategy for reducing mortality and preventing untimely cancer deaths. By challenging existing guidelines and emphasizing the importance of addressing healthcare disparities, these findings have significant implications for improving breast cancer screening practices and outcomes. Further research and consideration of these recommendations may lead to better health outcomes for women across different demographic groups.
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