Fewer US Women in their 40s Received Screening Mammos

Fewer American women in their 40s have undergone preventive mammograms since the release of controversial recommendations against routine mammography for women in this age group, Mayo Clinic researchers found.

Researchers found a 5.72 percent decrease in mammograms performed among women aged 40 to 49 - "a small but significant decrease,” said Nilay Shah, PhD, a researcher at the Mayo Clinic Center for the Science of Health Care delivery and co-author of this study.

"This is consistent with the context of the guidelines change,” Shah said. “A modest effect is also in line with the public resistance to the guidelines change and the subsequent release of conflicting guidelines."

The dip resulted in about 54,000 fewer mammograms in this age group over the course of a year. The researchers reviewed mammography rates of almost 8 million women, aged 40 to 64, before and after publication of the 2009 U.S. Preventive Services Task Force (USPSTF) guidelines - between January 2004 and December 2010. Their results were presented this week at the Academy Health Annual Research Meeting in Orlando, Fla.

Annual screening mammograms have long been recommended by organizations such as the Mayo Clinic, keeping with those of the American Cancer Society. However, in 2009, the USPSTF guidelines were updated, not recommending annual exams, but recommending that routine biennial screening of women younger than 50 be only performed on an individual basis, not as routine.

“The 2009 USPSTF guidelines resulted in a significant backlash among patients, physicians and other organizations, prompting many medical societies to release opposing guidelines,” said Shah. “We were interested in determining the impact that the recommendations and subsequent public debate had upon utilization of mammography in younger women.”

Sandhya Pruthi, MD, a consultant at the Mayo Clinic’s Breast Clinic, noted, “Screening mammography is not a perfect exam, but it is the best available tool to detect cancer early. Early detection can lead to better options and possibly less aggressive treatments.”