New breast cancer guidelines seen as unsafe: poll

NEW YORK Mon May 30, 2011 3:02am EDT

NEW YORK (Reuters Life!) - More than eight out of 10 women say new guidelines recommending against routine breast cancer screening of women under 50 are "unsafe," according to an opinion poll.

But most of the women also seriously overestimate their risk of developing the disease, researchers from the University of Massachusetts Medical School in Worcester found.

"Indeed, they have been exposed to consistent and high profile media campaigns, endorsed by medicine and a variety of interest groups, that have indoctrinated them into the concepts that mammograms lead to early detection and early detection saves lives," Autumn Davidson and other researchers wrote in the American Journal of Obstetrics and Gynecology.

The controversy over screening mammography flared up in late 2009, when a government-funded group of independent experts decided to change its recommendations.

Instead of advising annual mammograms in all women age 40 and above, the U.S. Preventive Services Task Force (USPSTF) said women shouldn't routinely get screened until they hit 50, and those between 50 and 74 should only have mammograms every two years.

What the group didn't say, though, is that no women under 50 should be screened -- it left that up to the individual woman and her doctor to decide, based on her personal risk factors and preferences.

But the USPSTF recommendations flew in the face of many years of aggressive PR campaigns, and met staunch resistance from advocacy groups, news organizations and medical groups.

To find out what women themselves thought, Davidson and her colleagues gave questionnaires to 247 women in their 40s who came to the hospital for an annual well-woman exam.

More than eight out of 10 of the women said they wanted yearly mammograms, felt the new guidelines were unsafe, and wouldn't delay screening until they were 50.

Most of them also had an inflated sense of their breast cancer risk. On average, they put U.S. Women's lifetime risk of developing the disease at 37 percent.

But scientists agree that over their lifetime, 12 percent, or one in eight women, will get breast cancer.

According to Michael LeFevre of the USPSTF, about 30 out of 1,000 40-year-olds will die from breast cancer in the absence of screening. But if screening is started at 50 and done every two years until the women hit 75, seven of those deaths would be prevented.

Starting at age 40 instead would stave off one more death.

That extra risk reduction is real for individual women, but comes with a price tag.

LeFevre said that mammography is painful for some women, and there will be a false alarm for one in two who are screened annually in their 40s. That is, the mammogram shows a suspicious mass that turns out not to be dangerous.

In the meantime the woman has gone through additional testing, which exposes her to more radiation, and sometimes had a painful, invasive and expensive biopsy done.

"Some women respond with increased stress and anxiety. The decision should be an individual one," he said.

"To encourage women to have mammography there have been some fairly strong public relations campaigns."

Elizabeth Thompson, president of advocacy group Susan G. Komen for the Cure, said her group worried that the new recommendations would prevent women in their 40s from being reimbursed for screening.

It recommends, as do many others, that women in their 40s should have an annual mammogram each year if they are of average risk.

"I don't think today that we have fear-mongering when one in three women will be diagnosed with (any form of) cancer in their lifetime, and one in two men," she told Reuters Health, adding that the survey size was small and perhaps not representative.

(Reporting by Frederik Joelving at Reuters Health; editing by Elaine Lies)

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