Black women should potentially start breast cancer screening eight years earlier than other patients, according to a new analysis published Thursday in JAMA Network Open.
The disease is the second-leading cause of cancer death in women, with substantial disparities by race, particularly in its early-onset form. Researchers recently sought to determine whether screening ages should be adjusted to help alleviate differences in outcomes, analyzing mortality data from more than 415,000 patients.
“Study findings suggested that when breast cancer screening was recommended to start at age 50 years for the general female population, Black females should start screening eight years earlier, at age 42 years, whereas white females could start at age 51 years,” corresponding author Mahdi Fallah, MD, PhD, with the German Cancer Research Center in Heidelberg, and colleagues concluded. “These findings suggest that health policymakers and clinicians could consider an alternative, race and ethnicity-adapted approach in which Black female patients start screening earlier.
Fallah et al. utilized a nationwide sample of U.S. breast cancer-death data spanning 2011 to 2020. They calculated the risk-adapted starting age for breast cancer screening based on 10-year cumulative risk of death tied to age, race and ethnicity. Black women were found to have an elevated risk of dying due to early onset breast cancer, necessitating the need for earlier screening. The analysis also determined that American Indian, Alaska native and Latina females should ideally start screening at 57 years, while those of Asian or Pacific Islander origin should begin at 61.
The analysis did not assess any potential harms associated with screening women at a younger age, nor explore specific imaging modalities. However, the authors pointed to a previous modelling study, which found that biennial mammograms for Black women beginning at age 40 was associated with a 57% decrease in the mortality gap between white women.
“The current one-size-fits-all policy to screen the entire female population from a certain age may be neither fair and equitable nor optimal,” the authors noted. “To optimize the benefit of screening, risk-adapted starting ages of screening based on known and readily available risk factors, such as race and ethnicity, may be recommended.”
Read much more in JAMA below.
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.