Adoption of new guidelines recommending screening mammography every two years for women ages 50 to 74 would result in breast cancer screening that is equally effective, while saving the United States $4.3 billion a year in health care costs, according to a study led by UC San Francisco.
The study compares three possible mammography screening strategies with a model of current U.S. screening practices.
The article appears on February 4, 2014 in Annals of Internal Medicine.
The authors call for the adoption of guidelines developed in 2009 by the U.S. Preventive Services Task Force (USPSTF). Under those guidelines, in addition to biennial screening for women age 50 to 74, women age 40 to 49 would be screened according to other risk factors, and women 75 and older would be screened depending on the presence or absence of other diseases.
The study was led by Laura J. Esserman, MD, MBA, professor of surgery and radiology at UCSF and an internationally known leader in the field of breast cancer.
"The USPSTF guidelines are based on the best scientific evidence to date," said Esserman, director of the Carol Franc Buck Breast Care Center at the UCSF Helen Diller Family Comprehensive Cancer Care Center. "What we need now is a better way to assess breast cancer risk and implement a more risk-based approach to screening. We have demonstrated that the resources for doing this are already in the system. We should redirect them to learning, enabling change, and improving outcomes."
According to the authors' estimate, approximately 70 percent of women in the U.S. were screened for breast cancer in 2010, at a cost of $7.8 billion. Some women are screened annually, some biennially, and some are screened on an irregular basis.
The scientists compared this current picture of breast cancer screening with three simulated models: annual screening of 85 percent of women age 40 to 84, in accordance with recommendations from the American Cancer Society and many other policymaking organizations, at an annual estimated cost of $10.1 billion; biennial screening of 85 percent of women age 50 to 70, in line with guidelines used in many European countries, at an annual estimated cost of $2.6 billion; and screening in accordance with USPSTF recommendations, which the authors estimate would cost $3.5 billion per year at a screening rate of 85 percent.
