Re-examining current breast cancer screening: An analysis of the 2009 U.S. Preventive Services Task Force guidelines for breast cancer screening

Abstract

ABSTRACTThe U.S. Preventive Services Task Force (USPSTF) released new mammography screening guidelines in November 2009. The panel’s comprehensive review of evidence for this preventive service concluded that the net benefit of screening mammography was too small to justify universal screening for women younger than 50 years of age but advocated continuing universal screening, though biennially rather than annually, for women ages 50–74 years. Under these new recommendations, it is possible undetected early breast cancers may increase and result in increases in breast cancer morbidity. This policy analysis assessed the impact of the new guidelines regarding whether the policy changes have affected breast cancer detection and treatment in the ensuing 5 years, and whether these guidelines may affect morbidity and mortality from breast cancer in the future. Trade-offs are present in cost-effectiveness and earlier detection with better treatment for women ages 40–49 years. Follow-up studies will be crucial to monitor changes in outcome for mortality and surgical intervention and ascertain the full impact of the new guidelines for women younger than 50 years.