Should There Be an Upper Age Limit for Annual Screening Mammography?
Posted: Monday, April 13, 2020
Women older than age 75 do not appear to benefit from annual screening mammography, according to recent findings by Xabier García-Albéniz, MD, PhD, of Harvard T.H. Chan School of Public Health, Boston, and colleagues. The results of the observational study with a target trial emulation approach were published in the Annals of Internal Medicine.
“There is limited trial evidence and dim prospects for future trials to address the important clinical question of how long women should continue with breast cancer screening,” stated the study authors. “Our estimates suggest that continuing to screen women aged 70 to 74 would reduce 8-year mortality. In contrast, continuing to screen women aged 75 years or older does not seem to affect 8-year breast cancer mortality.”
Medicare beneficiaries enrolled in Parts A and B between 1999 and 2008. Study participants had no breast symptoms in the previous 9 months, a perceived life expectancy of at least 10 years, and no past mammography screening; they were eligible for analysis by age cohort: 70 to 74 years and 75 to 84 years. Clones for 264,274 women were created and assigned to either a “stop screening” strategy group (434,644 person-years) or a “continue screening” strategy group (758,127 person-years). All were followed until death, disenrollment from fee-for-service Medicare, or December 2008, with a median follow-up of 16 months.
Among the women between the ages of 70 and 74, the 8-year breast cancer mortality risk was 2.7 in the “continue screening” group and 3.7 in the “stop screening group.” In the women between the ages of 75 and 84, the 8-year breast cancer mortality risk was 3.8 in the “continue screening” group and 3.7 in the “stop screening group.” Study authors suggested that any confounders not accounted for may overestimate the benefits of mammography screening.
Disclosure: For full disclosures of the study authors, visit annals.org.