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From NPR News, this is ALL THINGS CONSIDERED. I'm Melissa Block.


And I'm Robert Siegel.

First this hour, the latest in the decades-old controversy over when women should get mammograms. Today, a panel of leading health experts funded by the government announced new recommendations. They say the average American woman can wait until she's 50 to start getting mammograms. That differs from current recommendation which suggest women begin getting screened at age 40.

NPR's Brenda Wilson explains.

BRENDA WILSON: Just last month there were news reports that the American Cancer Society was wavering on annual screening for breast cancer. They're not. Now comes the U.S. Preventative Services Task Force, which is changing their guidelines.

Dr. DIANE PETITTI (Vice Chair, Preventative Services Task Force): The task force is now recommending that women age 40 to 49 not be routinely screened for breast cancer.

WILSON: Task force Vice Chair Dr. Diane Petitti says the key word here is routinely. The guidelines are for the average woman who doesn't have a high risk for breast cancer, such as women with a family history of breast cancer and African-American women. She says the average woman can start later and doesn't need to be screened every year.

Dr. PETITTI: It's recommending that women age 50 to 74 be screened every other year, rather than every one to two years as was previously recommended.

WILSON: Petitti says the task force changed its existing policy because of a number of recently published studies. The most important, she says, was conducted in the United Kingdom and followed more than 160,000 women who were randomly selected for mammograms.

Dr. PETITTI: It showed, as other trials have showed, that mammography starting at those ages reduces breast cancer mortality. What's important about it is it permitting more precise estimate of the size of the benefit from starting screening at age 40 to 49, compared with starting later.

WILSON: Along with others studies, that more precise estimate tipped the balance against yearly screening under age 50. Even though mammograms reduce the death rate by roughly 15 percent for women in both their 40s and 50s, more women in their 50s develop breast cancer. Petitti says the benefit of screening women over 40 is small when it's compared to the very real harm of having something detected that isn't cancer.

Dr. PETITTI: The harms are related to false positive tests. In the process of moving from a positive test to a false positive test, there are the psychological anxiety, digital imaging tests and ultimately perhaps even a biopsy.

WILSON: But some people think it's worth it.

Dr. TERRY FONTHAM (President, American Cancer Society): I'm one of those women who has certainly screened positive on mammograms and did not have breast cancer, and I've had to go back for re-screens.

WILSON: Terry Fontham of the American Cancer Society says the society is continuing to recommend annual screening for women 40 and older, because that's the best way to detect cancer at an early stage.

Dr. FONTHAM: Breast cancer is the most commonly diagnosed cancer in women, the number two killer. So, despite the increased anxiety and increased follow-up, we think the bottom line is saving lives.

WILSON: Fontham says the task force's recommendation could cost women.

Dr. FONTHAM: If a woman wanted to begin in her 40s, she would certainly be free to do so, but that would not be reimbursable.

WILSON: Insurance coverage and cost did not factor in the task force's recommendation, Petitti says, and emphasize that women can still choose to be screened at 40.

Dr. PETITTI: I hope that women will see the recommendation as being about better information, for better decision making and for better choices between starting at age 40 to 49 compared with starting later.

WILSON: There will be future opportunities, she says, if new evidence emerges. And she hopes that it helps identify women who are at high risk, so that even fewer women have to be screened for breast cancer.

Brenda Wilson, NPR News.

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