health strategy review (HSR)
management, engineering and
technology review
Joaquim Cardoso MSc.
Senior Research and Strategy Officer (CRSO),
Chief Editor and Senior Advisor
January 22, 2023
The recent update to breast cancer screening recommendations in the United States by the US Preventive Services Task Force (USPSTF) has sparked concern and reignited debates over the costs, timing, and approaches of mammogram screening.
- The proposed update lowers the initial age for routine mammogram screening from 50 to 40 and
- recommends screening every other year up to age 74 for women at average risk of breast cancer.
One major concern is the potential financial burden of follow-up tests after an abnormal screening result.
High out-of-pocket costs have been shown to deter some women from seeking necessary diagnostic imaging or biopsies, potentially leading to worse health outcomes.
The update has also triggered debates over the frequency and starting age for screening.
Organizations providing screening guidance have differing recommendations,
- with the USPSTF advising screening every other year,
- the American College of Radiology (ACR) advocating annual screening,
- and the American College of Obstetricians and Gynecologists (ACOG) suggesting either annual or biennial screening.
The USPSTF’s draft sets a uniform age to begin screening, but some experts argue for a more nuanced approach based on racial and ethnic risk variations.
The issue of screening options for women with dense breasts is complex, as dense breasts increase the risk of breast cancer, and mammography may be less effective in identifying cancer in these cases.
The USPSTF maintains an “I” grade for additional screening beyond mammography for these women due to insufficient evidence on benefits and harms.
Support for ending copay requirements for follow-up tests after a positive mammogram finding is widespread, …
with calls for expanded coverage of follow-up testing to ensure routine screening and diagnostic tests are accessible.
Efforts are underway in Congress to end copays for breast screening, and discussions between primary care physicians and patients about breast cancer screening will incorporate the finalized USPSTF guidelines.
As evidence evolves, healthcare professionals are urged to adjust their guidance to individual patient needs, considering various factors to determine the most suitable screening approach.
Nonetheless, some uncertainties remain about optimal screening practices and costs.
Originally published at:
This is an Executive Summary of the article “US Mammogram Update Sparks Concern, Reignites Debates”, published on Mescape, and authored by “Kerry Dooley Young”
