By Maria Perno Goldie, RDH, MS
The American College of Obstetricians and Gynecologists now recommends annual screening beginning at age 40.Previous guidelines from the American College of Obstetricians and Gynecologists (ACOG) recommended screening every 1 to 2 years for women in their 40s and annual screens beginning at age 50 (JW Womens Health Apr 21 2011). Now, two significant observations have provided the basis for the ACOG's decision to recommend annual screening for women in their 40s:• Mean sojourn time (the period during which tumors can be detected by screening before they become symptomatic) is shorter in women who are younger than 50 compared with older women. More-aggressive tumors characteristically have shorter sojourn times.• Reductions in mortality associated with screening are similar for women in their 40s and 50s.More-frequent screening is associated with more false-positive screens. Because of the high rate of false-positive screens and the large number of screens needed to prevent one breast cancer death among women in their 40s, the 2009 U.S. Preventive Services Task Force guidelines recommended that routine screening mammography be deferred until women reach age 50 and that screening be biennial (JW Womens Health Nov 16 2009). The new ACOG guidance acknowledges these concerns as well as the potential for false-positive mammograms to cause anxiety. Nonetheless, the ACOG also points out that U.S. women generally cope well with such anxiety.The ACOG continues to recommend clinical breast exams annually for women who are aged 40 and every 1 to 3 years for younger women (age range, 20–39). In addition, the ACOG encourages breast self-awareness for women who are aged 20.ACOG Committee on Practice Bulletins–Gynecology. Practice Bulletin No. 122: Breast cancer screening. Obstet Gynecol 2011 Aug; 118: 372. (dx.doi.org/10.1097/AOG.0b013e31822c98e5)
The American College of Obstetricians and Gynecologists now recommends annual screening beginning at age 40.Previous guidelines from the American College of Obstetricians and Gynecologists (ACOG) recommended screening every 1 to 2 years for women in their 40s and annual screens beginning at age 50 (JW Womens Health Apr 21 2011). Now, two significant observations have provided the basis for the ACOG's decision to recommend annual screening for women in their 40s:• Mean sojourn time (the period during which tumors can be detected by screening before they become symptomatic) is shorter in women who are younger than 50 compared with older women. More-aggressive tumors characteristically have shorter sojourn times.• Reductions in mortality associated with screening are similar for women in their 40s and 50s.More-frequent screening is associated with more false-positive screens. Because of the high rate of false-positive screens and the large number of screens needed to prevent one breast cancer death among women in their 40s, the 2009 U.S. Preventive Services Task Force guidelines recommended that routine screening mammography be deferred until women reach age 50 and that screening be biennial (JW Womens Health Nov 16 2009). The new ACOG guidance acknowledges these concerns as well as the potential for false-positive mammograms to cause anxiety. Nonetheless, the ACOG also points out that U.S. women generally cope well with such anxiety.The ACOG continues to recommend clinical breast exams annually for women who are aged 40 and every 1 to 3 years for younger women (age range, 20–39). In addition, the ACOG encourages breast self-awareness for women who are aged 20.ACOG Committee on Practice Bulletins–Gynecology. Practice Bulletin No. 122: Breast cancer screening. Obstet Gynecol 2011 Aug; 118: 372. (dx.doi.org/10.1097/AOG.0b013e31822c98e5)
Maria Perno Goldie, RDH, MS
To read previous articles in RDH eVillage FOCUS from 2011 written by Maria Perno Goldie, go to articles.
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