Screening Mammography In Women Beyond Age 75 Years Remains Controversial
The potential benefits of averting breast cancer deaths should be weighed against the potential harms of overdiagnosis when considering screening for women over 75
In a new BCSC study, investigators constructed a microsimulation cost-effectiveness model using Breast Cancer Surveillance Consortium data and Surveillance Epidemiology and End Results (SEER) data to estimate the costs, health benefits, and harms of screening mammography beyond age 75 years. Model simulations were run for subsets of women defined by comorbidity level from age 65 until age 100 or death, stopping mammography at age 75 years, age 80 years, age 85 years, or age 90 years. Annual mammography beyond age 75 was not cost-effective, regardless of comorbidity level. Biennial mammography from age 75 to 79 was cost-effective, but the health benefits were small, and cases of overdiagnosis were double the number of averted breast cancer deaths. Biennial mammography beyond age 80 was not cost effective. These results suggest that the potential benefits of averting breast cancer deaths should be weighed against the potential harms of overdiagnosis when considering screening for women over 75.
Schousboe JT, Sprague BL, Abraham L, O'Meara ES, Onega T, Advani S, Henderson LM, Wernli KJ, Zhang D, Miglioretti DL, Braithwaite D, Kerlikowske K. Cost-Effectiveness of Screening Mammography Beyond Age 75 Years : A Cost-Effectiveness Analysis. Ann Intern Med. 2021 Nov 23. Epub ahead of print. PMID: 34807717. https://doi.org/10.7326/M20-8076. [Link to article]
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Posted by: John T Schousboe