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Mammograms 'less use for older women'
 Older women may not benefit from breast scans |
Breast screening may have limited use for older women, researchers have said.
A team from the University of California, San Francisco (UCSF) have developed a computer model to test the effectiveness of mammogram tests for breast cancer.
They found that mammography screening after the age of 69 results in only a small gain in life expectancy, and is only moderately cost-effective.
 There are downsides to mammograms as women get older and only a small gain in life expectancy from continuing screening  |
| Karla Kerlikowske, lead researcher |
However, a pilot is currently taking place to routinely invite those up to 69.
Women of all ages are able to request a mammogram.
Karla Kerlikowske is assistant professor of medicine and epidemiology and biostatistics, and director of the Women Veterans Comprehensive Health Care Center at the SF Veterans Administration Medical Center.
She said: "There are downsides to mammograms as women get older and only a small gain in life expectancy from continuing screening.
The researchers developed a computer model using population-based cancer and mortality data to compare the life expectancy of 10,000 hypothetical 65-year-old women undergoing one of three breast cancer screening strategies.
They assumed that screening mammography would reduce breast cancer mortality by 27% as it has been reported to do in women aged 50 to 69 years old.
According to the model, if women underwent screening every two years until age 69, 148 would die of breast cancer by age 85.
Screening up to 79
If screening were continued until age 79 in women with high bone mineral density - which is a good predictor of breast cancer risk - 9.4 breast cancer deaths would be averted and would add, on average, 2.1 days to life expectancy among the women screened.
Expanding the mammography screening programme for all women up to age 79, including those women with low bone mineral density, would avert 1.4 additional deaths and add, on average, 0.3 days of life per woman screened.
Looked at another way, screening women from the age of 69 to 79 prevents only 10.8 breast cancer deaths, and adds, on average, just 2.5 days to a woman's life.
The researchers say the impact of continued screening is limited because older women have a shortened life expectancy and a high risk of death from other causes.
They argue this small benefit must be balanced against the downside of screening, which includes increased anxiety and the risk of false-positive results.
Julietta Patnick, national co-ordinator of the NHS Breast Screening Programme, said the research provided firm evidence to back the policy of not routinely inviting women in their 70s for screening.
"Even if we decided to extend screening to women aged 69, that would be in line with this paper," she said.
She said the paper might also help the campaign counter charges, made by organisations such as Age Concern, that it was operating a policy of ageism and discrimination.
The UCSF study is published in the Journal of the American Medical Association.
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| University of California, San Francisco |
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| Breast Cancer Campaign |
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| Breakthrough Breast Cancer |
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