Risky NEW mammography guidelines for women over 40

(NaturalHealth365)  A major update from the U.S. Preventive Services Task Force (USPSTF): women in America should now undergo breast cancer screenings via X-ray mammography technology every two years – starting as young as age 40.

This is a drastically different stance from the one the USPSTF held just seven years ago when they recommended biennial mammography screening for women starting at age 50.  What changed?  And, if providers and patients heed these recommendations, will younger women be exposed to unnecessary risks associated with recurrent X-ray exposure?

MAJOR revision to breast cancer screening recommendations for American women – and many ask why, knowing the risks associated with mammography technology

According to their website, the USPSTF was established in 1984 as “an independent, volunteer panel of national experts in prevention and evidence-based medicine.” Their stated mission is “to improve the health of people nationwide by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications.”

Panel members are providers from a wide range of fields, including “preventive medicine and primary care, including internal medicine, family medicine, pediatrics, behavioral health, obstetrics and gynecology, and nursing.”

Here’s why they’re making headlines today:

On May 9, 2023, the Task Force updated their recommendations for breast cancer screening to include biennial mammograms for women starting at age 40.  They go on to justify their updated position by referring to “[n]ew and more inclusive science about breast cancer in people younger than 50.”

(Note: in their announcement, the USPSTF note that their recommendations “are independent of the U.S. government.  They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.”)

To be clear, there’s no question that breast cancer is a potential concern for many of us and our loved ones.  According to the United States Centers for Disease Control and Prevention (CDC), about 1 in 8 American women will get breast cancer at some point in their lifetimes.  But do the potential so-called benefits of early mammography screening truly outweigh the potential risks?

Here’s the thing:

Conventionally speaking, mammography screening is thought to reduce the rates of cancer-related deaths.  Yet, on the other hand, plenty of research shows a recent decline in breast cancer death rates even in countries where screening is not routine … suggesting that other factors (such as better treatments) and not screening could explain improved survival rates.

There are other things to consider, too:

First, according to the CDC, less than 10 percent of all new breast cancer diagnoses in the United States each year affect women under the age of 45.  While certain younger women do have an increased risk of breast cancer based on personal risk factors (including family history and whether they are carriers of certain genes linked to breast cancer), to make a blanket recommendation to all 40- to 45-year-old women, regardless of their personal risk, is questionable.

Second, many conventionally trained physicians will say that a standard mammogram exposes a person to far less ionizing radiation than a typical chest X-ray – about 0.4 millisieverts (mSv), to be exact.  Plus, if you check with the Environmental Protection Agency (EPA), they too will say that the amount of radiation exposure associated with a mammogram is ‘very small’ compared to the average person’s annual radiation exposure from other natural background sources (about 3.0 mSv), which includes things like exposure to radon within the home.

But this argument brings up an obvious question…

If women are already exposed to background radiation every year, what are the risks of purposefully exposing themselves to even more with biennial mammograms that may not be necessary?  Indeed, if a woman follows the USPSTF recommendations, she will have exposed herself to an additional 2 mSv of radiation (nearly an extra year’s worth) before age 50 that she could have avoided otherwise.  How might that affect her health?

By the way, in case you’re wondering, the CDC warns that “additional exposures [to ionizing radiation] can lead to an increase in the possibility of developing cancer later in life.”

Here’s one major risk of mammograms that you haven’t heard about

Third, you might find it interesting to note that “overdiagnosis” is considered one of the chief risks of mammograms.  Even the USPSTF has acknowledged this.

Overdiagnosis is different from a false positive, in which a screening test confirms a breast cancer diagnosis even though the woman does not have breast cancer (which is extremely costly and emotionally harmful, of course).

Instead, overdiagnosis (according to the USPSTF) is “the diagnosis and treatment of noninvasive and invasive breast cancer that would otherwise not have become a threat to their health, or even apparent, during their lifetime.” Understandably, overdiagnosis could lead to excessive risk, harm, and emotional and physical stress (not to mention financial strain).

And finally, let’s not ignore the potential financial incentive here.  According to a 2021 paper published in the Journal of Economic Perspectives, annual costs associated with mammograms bring in a stunning $2.1 billion – and that’s just among American women in their 40s with private health insurance.

We ask again: do the potential benefits of earlier mammography use outweigh the potential risks (of radiation exposure, overdiagnosis, false positives, etc.)?  And if only certain younger women who truly have a higher risk of breast cancer based on individual factors would stand to benefit from earlier screening, why is this recommendation being made to all women in this age group?

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Sources for this article include:

USpreventiveservicestaskforce.org
USpreventiveservicestaskforce.org
CDC.gov
Aeaweb.org
Komen.org
CDC.gov
EPA.gov

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