An update to a 23-year-old study suggests that screening women for breast cancer at the age of 40 could save more lives.
A team from Queen Mary University of London reviewed information on 160,921 women between 39 and 41 years old, invited between October 1990 to September 1997. These women were randomly assigned - one part were subjected to annual breast screening while the other had to wait for eligibility for NHS screening. In the UK, women are offered breast screening every three years from their 50th year to their 71st birthday.
The results of their study are published in the latest journal Lancet Oncology.
SAN FRANCISCO - AUGUST 17: CT Tech Sandra Davis looks on as breast cancer patient Heraleen Broome, who is participating in a clinical trial, runs through a CT scan at the UCSF Comprehensive Cancer Center August 17, 2005 in San Francisco, California.
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Updating a Long-Term Study
In the study, researchers stratified the women in a 1:2 ratio, with 53,883 women (33.5%) assigned to the intervention group, i.e. the women with annual breast screening. On the other hand, 106,953 women (66.5%) were placed in the control group. Members of the intervention group were informed through mail while those in the control group remained unaware of the study.
The researchers behind the UK Breast Screening Age Trial have found that women who received their screening at age 40 to 49 led to as much as a 25% reduction in breast cancer mortality within ten years of following up. It translates to only 83 deaths among the women in the annually screened group. In the control group, 219 deaths were recorded.
From the data, the research team then proposed that an earlier start for annual breast screening can reduce breast cancer mortality. Moving the lower age limit for regular screening from 50 years old down to 40 could save lives.
The Debate on Breast Screening Age
"This is a very long-term follow-up of a study which confirms that screening in women under 50 can save lives," explained Professor Stephen W. Duffy. He is a member of the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine at the Queen Mary University of London and the lead researcher in the study.
The QMU Professor also explained that the benefits might actually be better than the data presents. He noted that the study began in the 1990s, with a lot of technological and medical advancement creating better treatment and diagnosis tools against breast cancer.
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Proposing to move the minimum age for regular breast screening opens up the old debate on when to start the procedure. Recommendation about this matter varies, with different government agencies and independent studies offering different suggestions. A 2015 study from the American Cancer Society reports that mammography screening in women aged 45 to 54 years old be screened actually. On the other hand, the European Breast Guidelines proposes an organized screening program for women at 40 to 75 years old.
In a commentary, however, Anthony B. Miller, from the Dalla Lana school of public health at Toronto University in Canada, notes that the discussion of the breast screening age is not yet done. Miller noted that the study did not have another control group of women that received no screening at all. He left the debate on screening open, but emphasized instead that women should practice breast awareness, adding that mammography be used as a diagnostic tool.