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American Cancer Society Changes Mammogram Guidelines


We have major news today about how women should be screened for breast cancer. For the first time in more than a decade, the American Cancer Society is changing its recommendations. And NPR health correspondent Rob Stein is here to talk about it. What’s the recommendation?

ROB STEIN, BYLINE: Well, Steve, you know, for years, the Cancer Society’s been telling women that once they hit 40, they should go in and get a mammogram and then they should get one every year after that. And today, the Cancer Society’s saying it’s changing that. It’s pushing it back. And they’re saying that women can wait longer. They can wait five years longer until they’re 45 before they start screening.

INSKEEP: Get tested less – why would that be a good idea?

STEIN: Well, they’re basically saying that there are benefits of screening, but there are – can be significant downsides to screening. And the big downside is false alarms. If you screen millions of women every year, inevitably, some are going to get false alarms. And false alarms don’t just make women anxious. It could create all sorts of problems.

It can send them back for additional mammograms, which could then result in them undergoing biopsies, which could find something that may or may not be cancer, may or may not be something that ever turns out to be life-threatening. But they end up getting lots of treatment anyway, like radiation, chemotherapy, surgeries like lymphadenectomies and even mastectomies sometimes.

INSKEEP: Well, now remembering this, Rob, isn’t the American Cancer Society then weighing into a much bigger debate? There’s been much discussion for quite some time about this problem.

STEIN: Yeah, well, what happened is back in 2009, there’s another group known as the U.S. Preventive Services Task Force that really opened up this can of worms. And so when it announced that it was recommending that women wait even longer until they’re 50 before they start screening and then get a mammogram every other year, ever since then, there’s been this really intense debate about what’s the right thing to do when it comes to mammograms.

Now, that’s not the only change that the Cancer Society’s making. So the first thing they’re saying is, OK, you can wait until you turn 45. Then they’re saying, OK, then you get one every year until you’re 54 and then once you turn 55, you can stop and start skipping your mammogram every other year. The important key message here is that this is for women at average risk for breast cancer, not women who have a family history or something like that.

INSKEEP: Isn’t there something that is counterintuitive that’s really going to trouble a lot of people here? You would think that if you have a medical problem, you would rather have the test and know. But the advice here is that sometimes it’s better not knowing what kind of minor ailments or potential ailments or false alarms you might have.

STEIN: Right. What they’re saying is that sometimes it’s better not to get bad information basically – basically be told that something is going to be a problem when it really is never going to be a problem. And the key here is that women in their early 40s are at such low risk for breast cancer that screening millions of them every year, inevitably you’re going to catch all sorts of false alarms and send women down this trail that was completely unnecessary. And if you just waited, you’re still going to catch the cancer later and you’re still going to save lives, and you’re going to - sort of that risk benefit analysis. It gets much better.

INSKEEP: Rob, thanks very much.

STEIN: Great to be here.

INSKEEP: That's NPR's Rob Stein. Transcript provided by NPR, Copyright NPR.

Rob Stein is a correspondent and senior editor on NPR's science desk.
Steve Inskeep
Steve Inskeep is a host of NPR's Morning Edition, as well as NPR's morning news podcast Up First.

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