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...part, the American Cancer Society holds firm to its position - recommending yearly mammograms for women beginning at age 40 - adamantly stating that it will not modify its guidelines. "We are not changing current recommendations at this time based on our initial review of the information provided by the task force," says Dr. Len Lichtenfeld, deputy chief medical officer for the ACS. (See pictures from an X-ray studio...
Congress mandates that Medicare cover annual mammograms for its beneficiaries, but if private insurers adopt the task force's policies, then many women may soon find themselves at odds with their doctors, who may continue to advise annual screenings even if patients have to pay for them out of pocket. "That would be a step backward, taking away an option from women and denying them the choice," says Dr. Mary Daly, chairperson of the department of clinical genetics at Fox Chase Cancer Center in Philadelphia...
...recommendations are based on analyses of two sets of data. In the first analysis the task force examined the results of existing trials on mammography, much of which had not changed since the panel last considered the issue in 2002; this time, however, the data was re-evaluated taking into account the current, and better, understanding of the potential harms associated with mammography - information that shifts the balance of risks versus benefits of screening...
...task force's second data set comes from computer-modeled predictions of breast-cancer incidence and death rates based on various screening scenarios. The models were run by researchers at the National Cancer Institute (NCI), who compiled data from six cancer centers around the country, and plugged it into 20 separate age- and time-based screening protocols - from screening women ages 49 to 69 every year and every two years, for example, to screening only women ages 60 to 69 every year and every two years as well. By switching from annual to biennial exams, these women would maintain...
Overall, the analysis suggests that mammography reduces the risk of dying from breast cancer 15% among women 39 to 49 years old. But the task force determined that while mammograms certainly reduced risk of death, that reduction was small in this age group in light of the risks associated with the screening. In order to save one life among 40- to 49-year-olds, doctors would have to perform yearly mammograms in 1,904 women over 10 years. Among older women, between ages 50 and 74, one death could be prevented for every 1,339 women screened for 10 years...