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Mammogram guidelines scale back screenings for younger women

Women are now recommended to get annual mammograms starting at age 45.

By Stephen Feller

WASHINGTON, Oct. 20 (UPI) -- The American Cancer Society announced new guidelines for breast cancer screening for women, suggesting women with an average risk not begin annual mammograms until age 45.

A debate has opened in recent months about over-testing and over-diagnosis for breast cancer, which some researchers have said causes undue stress on women, exposes them to unneeded treatments, and increases healthcare costs with no actual benefit to patients.

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"These recommendations are made with the intent of maximizing reductions in breast cancer mortality and years of life saved while being attentive to the need to minimize harms associated with screening," said Dr. Kevin Oeffinger, chair of the ACS breast cancer guideline panel and a physician at Memorial Sloan Kettering Cancer Center, in a press release. "The benefits, burdens, and judgment about that balance differ depending on a woman's age, health, values, and preferences. These recommendations recognize and reflect those differences."

According to the new guidelines, published in the Journal of the American Medical Association, women with an average risk of developing breast cancer -- based on family history, genetic testing or other risk factors -- should be screen annually between the ages of 45 and 54. The organization also recommends women with a life expectancy of less than 10 years not be screened based on the idea they will die with cancer but not from it.

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Researchers at the University of Washington reported in July that while increased screening for breast cancer had increased the number of tumors found, it had not decreased the number of deaths credited to the disease. Their conclusion was that overdiagnosis and overtreatment had not helped women, and may have been harming them.

While healthcare guidelines are not law and don't dictate what doctors and insurance companies will do, the potential for changes to perceptions and the resulting care have raised some concern.

"[The new guidelines] have the potential to lead to reduced accessibility to and coverage for health screenings from both private and public insurers," Judy Salerno, president and CEO of Susan G. Komen for the Cure, told the Washington Post.

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