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Vital Signs The Analyst's Perspective - October 2015 Issue

Vital Signs The Analyst's Perspective - October 2015 Issue

On October 20, 2015, the American Cancer Society (ACS) announced an update to its recommended breast cancer screening guidelines for women with average risk of breast cancer. In the new guidelines, the ACS recommended that “most women should begin annual screening at age 45 instead of age 40, and switch to every other year at age 55.” Mammograms can yield false-positive results, requiring additional testing or over testing. Also, mammograms can detect very low-risk cancers that would never cause women health problems had they never been treated, resulting in many women receiving treatment who would not have otherwise needed it, hence, over treatment.

The Analyst’s Perspective by Barbara Gilmore, Senior Industry Analyst, Life Sciences

The ACS is recommending screening for various cancers in an effort to detect cancers early, when they are easier to treat and cure. Breast cancer is the second-leading cause of cancer death in women in the United States, and preventative screening can be beneficial. The sooner cancers can be diagnosed and treated, the higher the chance of survival or cure. In the US, there are different screening recommendations coming from different organizations. In 2009, the US Preventative Services Task Force (USPSTF) recommended and currently recommends that women do not start getting breast mammograms until age , and then only get screened every two years, because too many screens may lead to over diagnosis and over treatment. The ACS recommends women should be screened more frequently based on their belief that screening catches cancers at earlier stages.

What does this mean? In the long run, large sums of money will be saved with the reduced numbers of mammograms and unnecessary over treatments. Until 2015, most studies of breast cancer screening had been performed on women older than years in the Medicare population. In 2015, physicians at Harvard Medical School and Boston Children’s studied the costs of false-positive mammograms and breast cancer over diagnoses among women aged , based on expenditure data from a major US healthcare insurance plan for the years 2011-2013.1 The costs associated with false-positive mammograms and over diagnoses were reported to be in excess of $ billion per year. It is important for women to recognize the risk factors for breast cancer, including a genetic predisposition, breast density, and family history, in making decisions about how frequently they would have breast screens. Knowledge of the total picture will help physicians make their patient care more personalized. The women who are most at risk and would benefit from the screening should be screened. The costs associated with screening and over treatment are substantial. How much money will be saved? Time will tell.


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