The new United States Preventive Services Task Force (USPSTF) Breast Cancer Screening Draft Recommendations 1 are a very good step forward. The Canadian Society of Breast Imaging (CSBI) recommends annual mammography screening for all average-risk women ages 40-49 and every 1-2 years for women 50 and older.
The USPSTF, Canadian Association of Radiologists, CSBI, and American Cancer Society, among others, agree that annual breast cancer screening saves the most lives. Medical experts agree and recommend yearly mammography for average-risk women aged 40 – 49.
The incidence of breast cancer is rising in younger women. The evidence shows that Black, Asian, Hispanic, Jewish and other minority women develop and die from breast cancer before age 50 — or even age 40 — more often than white women. Every woman should be assessed for breast cancer risk by age 30 to ensure an optimal tailored approach to screening.
The inclusion of Canadian women 40-49 years old in screening programs is associated with a significant increase in early detection of breast cancer at Stage I and a decrease in the proportions of breast cancer diagnosed at Stage II, III and IV, without increasing the overall incidence of breast cancer.2 This shift to an earlier stage of breast cancer at diagnosis is associated with a significant reduction in breast cancer mortality of about 40%. 3 Not only associated with reduced breast cancer deaths, breast cancer screening costs less to the medical system when treating early-stage screen-detectable breast cancers and is associated with much better patient outcomes.
The CSBI recommends that every woman 40 years and older should have the opportunity for informed decision-making and should not be denied screening if they choose it. Screening mammography should be available by self-referral to the provincial or territorial screening program for all women 40 years and older who choose to be screened after informed decision-making with accurate information about the balance of benefits and risks.
Approved by the CSBI Board of Directors on May 12, 2023
Canadian Society of Breast Imaging Position Statement on The new United States PreventiveServices Task Force (USPSTF) Breast Cancer Screening Draft Recommendations
References
1. Breast Cancer Screening: Draft Recommendation Statement. US Preventive Services Task Force; May 9, 2023. Available at https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/breast-cancer-screening-adults. Accessed on 05/12/2023.
2. The Impact of Organised Screening Programs on Breast Cancer Stage at Diagnosis for Canadian Women Aged 40–49 and 50–59. Breast Cancer Imaging and Therapy; 2022. Available at https://www.mdpi.com/1718-7729/29/8/444. Accessed on 05/11/2023.
3. Pan-Canadian Study of Mammography Screening and Mortality from Breast Cancer, JNCI: Journal of the National Cancer Institute, Volume 106, Issue 11, November 2014, dju261. Available at https://academic.oup.com/jnci/article/106/11/dju261/1496367. Accessed on 05/11/2023.