Currently, breast cancer screening starts at the age of 50 in most European countries. But there have been calls for this to start earlier for some time now. New research confirms that it is better to start ten years earlier and continue for at least five years longer.
In the Netherlands, women from the age of fifty receive a call for breast cancer screening approximately every two years. More than 70 percent of women respond to this. They then undergo a mammography that can detect tumors. They last receive a call around the age of 75. According to the RIVM For every thousand women aged 50, forty will die from breast cancer at some point. If women participate in the population survey, they have a 50 percent lower chance of dying from the disease than if they do not get checked.
Sweden and the US
There are some countries, such as Sweden and the US, where breast cancer screening starts as early as age 40. However, in most EU countries, experts still believe that this is not necessary, because the risk of breast cancer only increases significantly from the age of 50. Moreover, there are also disadvantages to screening, such as extra stress due to unnecessary follow-up testing.
Yet there is now a new study which shows that longer screening – from 40 to 79 years – can save lives. “There is an ongoing debate about breast cancer screening advice, especially when to start and how often,” said lead researcher Debra Monticciolo, a radiology professor at the U.S. Dartmouth College.
Screen longer
That is why she and her colleagues decided to take another look at the figures and compare the benefits of screening, such as the number of years of life gained and the number of deaths avoided, with the disadvantages, such as unnecessary but stressful biopsies and other additional tests. They looked at four options: biennial screening for women aged 50 to 74, biennial screening for women aged 40 to 74, annual screening for 40 to 74-year-old women and annual screening from 40 to 79 years.
The results are clear: annual screening is best for women between the ages of 40 and 79. This reduces the risk of dying from breast cancer by almost 42 percent. Biennial screening for women between the ages of 40 and 74 reduces the risk of death by 30 percent. If you start population screening at the age of 50, the number of deaths decreases by 25.4 percent. That sounds like a big difference, but it’s still small probabilities.
Also over 79 years old
“The most important point of our study is that annual screening from age 40 to at least 79 years leads to the greatest reduction in the risk of death. In this way, most cancer deaths are prevented and most years of life gained,” says Monticciolo. “There is a huge benefit to continuing screening until age 79 and it is even better if women over 79 continue to be screened.”
Disadvantages are not too bad
There are also disadvantages to so much more screening, but according to the researchers these are minor. The chance that a woman will receive a biopsy that was not necessary is less than 1 percent and the total for unnecessary additional testing is less than 10 percent.
“The risks of screening are not fatal and tolerable for most women,” the researcher responds. “But advanced breast cancer is often fatal. Breast cancer is easier to treat if it is found earlier. We can spare women additional surgeries and chemotherapy. It is simply a better idea to focus even more on early detection and that is what screening does.”
Monticciolo hopes that her study adds to the existing research that proves that it is better to start screening at the age of 40. “This study is important because it once again shows that there is a huge benefit to annual screening between the ages of 40 and 79 and that the disadvantages are small,” she says. “It comes down to valuing women’s lives. I hope doctors realize that.”
