Most (88%) physicians who participated in a survey published on Monday by JAMA reported that they recommend breast cancer screenings to women aged 45 to 49, with 81% recommending such screening to women aged 40 to 44, and 67% to women 75 and older.
Gynecologists were more likely than internal medicine and general practitioners to recommend screening in all age groups.
- Physicians who reported a preference in screening guidelines from the American Cancer Society (ACS) or from the American College of Obstetricians and Gynecologists (ACOG) were most likely to recommend screening for younger women.
The debate about guidelines for breast cancer screenings has been controversial, mainly because of the issue of which age groups would benefit from them. Women who are age 50 and older should see their doctors for a mammogram every two years, but these should be optional for women who are in the 40s, the U.S. Preventive Services Task Force stated in its updated breast cancer screening guidelines issued in January 2016. Data have also showed women who are up to 90 years old could benefit from mammograms.
Death rates for breast cancer decreased among all women in the U.S. from 2010 through 2014, the CDC reported in October 2016. However, the rate dropped by 2% per year for white women in the ages of 60 to 69 and only by 1% for black women in the same age group. Breast cancer mortality was also 41% higher among black women compared to white women.
There has also been an increase in the prevalence of obesity among black women, the CDC noted. Research published in The New England Journal of Medicine last year showed being overweight or obese is strongly linked to 13 types of cancer, including breast cancer in postmenopausal women. More weekly physical activity than the amount recommended by the World Health Organization (at least 600 metabolic equivalents minutes per week) could actually lead to lower risks of developing breast and bowel cancer as well as heart dieases and ischemic strokes, according to a 2016 study published in The BMJ.
The authors of the CDC report argued the trends among black women "might stabilize and decline by sustaining and increasing public health interventions to increase physical activity and promote a healthy diet." They pointed to previous research that showed screenings have "led to more cancers being diagnosed at an early stage, and more appropriate treatment of aggressive cancers in young black women."
Treatment tends to be based on research results from genetically testing whites more so than racial minorities, a Health Affairs post published last year suggested. But there are new efforts targeting the prevalence of cancer.
The National Institutes of Health embarked on a collaborative study last year with the goal of identifying the factors behind racial disparities in breast cancer risk by using precision medicine. Earlier this year, Cancer Treatment Centers of America partnered with healthcare company NantHealth and Allscripts to link clinical decision support with EHRs. Also, Tennessee-based Digital Reasoning, a software company, uses AI to help improve efficiencies with reports that indicate breast cancer.