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More evidence that screening mammograms is not necessary for many older women



By Lisa Rapaport

(Reuters Health) – Screening mammograms do not benefit women over 75 with chronic health problems – such as heart disease or diabetes – likely to end their life before they had cancer, a new study suggests.

Researchers analyzed data on 222,088 women who had at least one mammogram screening between 1999 and 2010 when they were between 66 and 94 years old. Researchers have followed most women for nine years or more.

During the study period, 7,583 women, or about 3%, were diagnosed with invasive breast cancer and 1,742 women, less than 1%, were diagnosed with pre-invasive malignancies known as ductal in situ carcinoma (DCIS). While 471 women died from breast cancer during the study, 42,229 died of other factors.

This means that women are 90 times more likely to die from causes other than breast cancer, researchers reported in the Journal of the National Cancer Institute. [1

9659002] "The presence of more chronic diseases increases the risk of dying from non-breast cancer causes, while has no effect on the risk of breast cancer or breast cancer death," says Dejana Braithwaite , senior author of the study and a researcher at the Lombardi Comprehensive Cancer Center at Georgetown University in Washington, DC

"This is a big deal because, as younger women may have a good reason to undergo in screening mammograms to detect breast cancer because their risk of dying from other factors is relatively low, this is not the case in older women, especially those with one or more chronic diseases, "Braithwaite said via email.

Women ages 75 to 84 are 123 times more likely to die of causes other than cancer in the east; this estimate is higher in women age 85 and older.

The 10-year risk of dying from breast cancer is small and does not change with age; it remained about the same from the age of 66 to 94, accounting for only 0.2% –0.3% of all deaths in the study.

On the contrary, the risk of dying from other causes increases with age and also increases with each additional chronic medical problem of a woman.

The purpose of screening mammography is to detect tumors before they are diagnosed in a physical exam, to catch cancer more easily. Ideally, this should mean fewer women are diagnosed if the lump is bigger, faster growing and harder to attack.

But some research suggests that screening too early or often can also catch small, slow-growing tumors that are unlikely to be fatal – without abduction in diagnosis of advanced cancer cases. Injuries to the screening may include unnecessary invasive tests and cancer treatments for tumors that will never cause disease in women or lead to their death.

The United States Preventive Services Task Force notes that there is insufficient evidence to recommend. for or against screening women age 75 or older. Many European breast cancer programs stop women screening between the ages of 69 and 74.

In the US, despite these recommendations, many women in their 80s and 90s still get screening mammograms, the study team notes.

One limitation of the analysis was that it only included women who continued receiving mammograms of screening as they age, and possible outcomes for all women in the population, including those who stopped taking mammograms, may be different, the researchers note.

"Our study included large numbers of older women who were unlikely to benefit from screening mammography," Braithwaite said. "Women aged 75 and older with chronic diseases are unlikely to benefit from ongoing mammograms, however, these findings underscore the need for more individualized screening techniques. , rather than making sweeping recommendations. " 2kcRguy Journal of the National Cancer Institute, online September 6, 2019.


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