There is no clear cut-off age to stop breast cancer screening, according to new data from the largest-ever study on mammogram screening outcomes.
Data from the study was presented this week at the Radiological Society of North America’s annual meeting.
Age-based cutoffs for screenings have been a source of controversy for many years in the healthcare field. Results from the massive study, however, support guidelines that support making breast cancer screening decisions based on individual patients and health status over a specific age, according to study researchers.
Data in the study came from over 5.6 million mammogram screenings performed over 7 years between January 2008 and December 2014 and across 150 facilities in 31 U.S. states. Patient demographic data, mammography and biopsy results were considered in the analysis, with over 2.5 million women over 40 in the study.
A total of 4 standard performance metrics were used to evaluate the data at each age group, including cancer detection rate, recall rate, positive predictive value for biopsies and biopsies performed.
The mean rate of cancer detection was clocked at 3.74 per 1,000 patients, with a recall rate of 10%, positive predictive value of recommended biopsies at 20% and for biopsies performed at 29%. In considering age between 40 and 80 years, metrics showed a gradualte upward trend in terms of cancer detection rate and biopsy prediction rate, but a downward trend in recall rate.
“All prior randomized, controlled trials excluded women older than 75, limiting available data to small observational studies. There has been a lot of controversy, debate and conversation regarding the different breast cancer screening guidelines, even among major national organizations, over the past few years,” Dr. Cindy Lee of the University of California, San Francisco said in a prepared statement.
Study researchers indicated that the results supported the argument that individual personal health history and preferences should be used to inform whether or not to stop screenings.
“The continuing increase of cancer detection rate and positive predictive values in women between the ages of 75 and 90 does not provide evidence for age-based mammography cessation,” Dr. Lee said. “We know that the risk of breast cancer increases with age,. With the uncertainty and controversy about what age to stop breast cancer screening, we want to address this gap in knowledge using a large national database.”
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