New
Service for TodaysSeniorsNetwork.com
readers...roll mouse over, click on
highlighted links in stories to review items
from Amazon
Now, keep up to date
with daily feeds of newly posted stories
about America's Seniors...click on the box
to the left
Mammograms
benefit women up to the age of 75 and
3-yearly screening intervals are best
Berlin, Germany: Breast cancer screening is
effective, appropriate and reduces deaths
from the disease in women aged up to 75
years old according to new research in over
860,000 women aged 70-75 presented today
(Friday) at the 6th European Breast Cancer
Conference (EBCC-6) in Berlin.
In another study of nearly 100,000 women
aged 50-62, also presented at EBCC-6 today,
researchers found that the best interval for
screening was every three years – a finding
that counters arguments that women should
have mammograms more frequently.
Many countries that run breast cancer
screening programmes offer it to women aged
between 50 and 70. However, in 1998 in The
Netherlands, the programme was extended to
women aged up to 75.
The results presented today suggest that
this is an appropriate upper age limit and
saves lives without causing substantial harm
by subjecting older women to over-diagnosis
and over-treatment.
This is the first study to provide firm
support for the idea that offering
mammograms to women up to the age of 75 is
effective, as, until 1998, very few women
were screened at this age.
Mr Jacques Fracheboud, a senior researcher
at the Erasmus Medical Center (Rotterdam,
The Netherlands), and his colleagues found
that from 2003, five years after screening
was extended to women aged 70-75, there was
a steady decline in deaths from breast
cancer among women aged 75-79.
By 2006 breast cancer mortality was 29.5%
lower than the average for the period
1986-1997 for this age group – a time when
breast cancer mortality in women aged 75-79
had remained stable. In 1986-1997 the
average was 166 deaths per 100,000 women
aged 75-79 and in 2006 it was 117 per
100,000.
It takes some years before a significant
effect from screening can be seen, therefore
breast cancer mortality was analysed for the
ages 75-79.
“That means that women, aged 70-75 at the
time that screening was extended to this age
group, have become five years older and the
reduction in breast cancer mortality shows
that the screening has started to have a
statistically significant effect,” Mr
Fracheboud told a news briefing.
Out of the 7.37 million screening
examinations performed between 1998-2006,
862,655 were for women aged 70-75. Among
women aged 50-69, 81.2% participated in the
screening programme, and 71.9% of women aged
70-75 took part.
However, the participation rate for these
older women increased significantly during
this period, rising from 62.5% in 1998 to
77.6% in 2006.
In the 50-69 age group, 12.8 per 1000 women
screened were referred for diagnostic
assessment as a result of screening and
breast cancer was detected in 4.5 per 1000,
giving a positive predictive value
(percentage of abnormal mammogram findings
that were confirmed as breast cancer) of
36%.
In the 70-75 age group, 16.4 per 1000 women
screened were referred for diagnostic
assessment and breast cancer was detected in
7.8 per 1000, giving a PPV of 47%.
“The difference shows that it is easier to
find breast cancer in older women due to
their breast tissue being less dense,” said
Mr Fracheboud.
“But it is not necessarily an argument for
continuing screening beyond 75 because many
tumours found at this stage are slow growing
and may never reach the stage of causing a
problem.”
He continued: “The results of our study
suggest that screening women aged 70-75 has
a strong impact on breast cancer mortality
and that it is effective and appropriate up
to 75 years.
"The
cost per mammogram is approximately €50 –
the same as for younger women. Before the
programme was extended up to 75 there was a
fear that older women would be more
expensive because fewer would participate
and it might take more time to screen them
due to reasons such as lower mobility.
However this seems not to be case, and
participation rose among the older women.”
In the second study – the UK Breast
Screening Frequency Trial – researchers
randomised nearly 100,000 women to have
either an annual or a three-yearly mammogram
after the date of the first screening to
which they were invited after their 50th
birthday.
In an earlier paper (European Journal of
Cancer 2002), the researchers had predicted
that annual screening would not result in a
further reduction in breast cancer mortality
over the three-year interval standard in the
UK. The actual mortality rates presented
today confirm this to be the case.
After an average follow-up time of over 13
years (the trial started in 1989), there
were 373 breast cancer deaths (out of a
total of 49,173) among the study group of
women invited to attend annual screening,
and 374 (out of a total of 50,162) in the
control group of women invited to
three-yearly screening.
Among
those women who actually attended the
screening (as opposed to the whole group of
women, including non-attenders), there were
209 breast cancer deaths in the study group
and 231 in the control group.
The researchers found no difference in
mortality rates when they looked at only
those cancers diagnosed during the
three-year screening periods.
The absolute risk of dying from breast
cancer was statistically insignificant
between the two groups, with the control
group having an absolute risk of only two
per cent more than the study group.
One of the authors of the study, Professor
Roger Blamey, a breast surgeon at Nottingham
City Hospital (Nottingham, UK), told the
news briefing: “There was a lot of criticism
of the UK for having a three-yearly interval
when breast screening was set up – screeners
and advocacy groups said, without evidence,
that it was too long an interval. Population
screening in the UK costs around €100m a
year. These results indicate that our
earlier predicted mortality figures were
accurate and that there is no evidence in
favour of shortening the current three-year
screening interval.”
...
...
...