An independent medical expert panel that advises the US federal government on preventive and primary healthcare recommends against routine screening mammography in women aged 40 to 49 years and suggests instead that the decision to start regular screening before the age of 50 should be an individual one.The recommendation, dated November 2009, comes from the US Preventive Services Task Force (USPSTF), a leading independent panel of private-sector experts in prevention and primary care, sponsored by the Agency for Healthcare Research and Quality (AHRQ) which is part of the US Department of Health and Human Services. The full statement with supporting documents is available on the AHRQ website.The USPSTF recommends against routine screening mammography for women under the age of 50 and that for women younger than this the decision to have mammograms every two years should be an individual one that takes into account the patient's individual context, including "the patient's values regarding specific benefits and harms".
The main reason for raising the age band from 40 to 50 comes from a new systematic review that incorporates a randomized controlled trial that showed the risk reduction from screening is greater for women aged 50 to 59 than for those aged 40 to 49. The USPSTF said that the trial estimated that the "number needed to invite for screening to extend one woman's life as 1904 for women aged 40 to 49 years and 1339 for women aged 50 to 59 years", and although the relative risk reduction is nearly the same for the two age groups, risk for breast cancer rises steeply from age 40 onwards, thus the absolute risk reduction from screening as shown by the number that would have to be invited, is greater for those aged 50 to 59 than for women aged 40 to 49.In their new Screening for Breast Cancer statement the USPSTF also recommends:Regular biennial screening mammography for women aged 50 to 74. Only 40 percent of the lives saved by mammographic screening are of women aged 40 - 49.
