OB-GYN specialists urge more aggressive breast cancer screening amid rising case counts
OB-GYN specialists are urging for more aggressive breast cancer screening amid rising case numbers among women under 40.
The American College of Obstetricians and Gynecologists issued updated clinical guidelines pertaining to mammography earlier this month. Previously, ACOG advocated that women are offered mammography beginning at 40, with those who have not initiated screening beginning to do so at 50. Now, the organization wants all women at average risk to begin at 40, while maintaining its guidance that women do so every 1 to 2 years.
In making its case, OB-GYNs highlighted increasing incidence of invasive breast cancer in younger women. Such cases climbed by an average of 2% each year for women in their 40s from 2015-2019, “demonstrating the importance of earlier screening.”
“There has been a concerning trend of increasing breast cancer diagnoses among women in their 40s, and new data shows that earlier screening could make a significant difference in decreasing breast cancer deaths,” Eve Zaritsky, MD, author of the clinical practice update, said in a statement. “While screening can sometimes cause anxiety for people and even unnecessary follow-up, the benefits of diagnosing breast cancer earlier outweigh those risks enough to warrant starting to get mammograms at age 40.”
The college also cited the “demonstrated greater net benefit of earlier screening,” along with the opportunity to improve health inequities. Black women have the highest rate of breast cancer mortality, even when adjusting for age and cancer stage at diagnosis. They also face higher rates of triple-negative breast cancer, the American College of Obstetricians and Gynecologists noted. Structural inequities must be addressed, with minority women often facing delays in screening follow-up, diagnosis and treatment.
“While earlier screening can make some improvements, there is still much work to be done in improving inequities and disparities in breast cancer care, and we hope that during this Breast Cancer Awareness Month, we can bring more attention to these issues,” Cherie C. Hill, MD, another co-author of the clinical practice update, said in the same statement.
ACOG’s updated recommendations are consistent with guidelines from the American College of Radiology, U.S. Preventative Services Task Force and the Society of Breast Imaging. OB-GYN specialists hope new data on beginning screening at age 40 will lead to greater consensus among medical societies while decreasing confusion for patients and clinicians.
The full clinical practice update will be published in the January issue of Obstetrics & Gynecology and can be found here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.