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Studies split on mammogram's usefulness for younger women

mammography November 30, 1997
Web posted at: 10:41 p.m. EST (0341 GMT)

(CNN) -- Two new studies on the usefulness of routine mammograms for women in their 40s are likely to add new fuel to the contentious debate on the subject.

The results of a Swedish study, reported in the American Cancer Society's journal Cancer, indicate that women in their 40s receive a substantial benefit from having regular mammograms to screen for breast cancer.

Researchers who evaluated more than 25,000 patients in Sweden found that a high-quality mammogram every 18 months for these women reduced breast cancer deaths by 45 percent.

"It's quite dramatic, and it's quite a bit larger than anything we've seen to date," says Robert Smith of the American Cancer Society. "But this is a new trial, using new technology."

But another study, in the American College of Physicians' Annals of Internal Medicine, suggested that routine mammograms for younger women would be so expensive that older women, who would benefit more from the screening procedure, could be denied access to mammograms in settings where resources are limited.

The report also said younger women have been left with exaggerated fears about their risk of contracting breast cancer, which is far more likely to strike after the age of 50.

While there is no controversy over the value of mammography for women 50 and older, there has been considerable debate over the value of having younger women undergo routine mammograms. One of the primary reasons is the cost of such routine screening versus the overall benefit.

A study by a group of doctors in California found that annual screening for women aged 50 to 69 costs $21,400 for every year of life saved. But for women in their 40s, the cost was $150,000 for every year of life saved.

The American Cancer Society recommends that women in their 40s have a mammogram every year, saying it is a necessary precaution because cancer tends to grow faster in younger women and is tougher to detect.

The National Cancer Institute, on the other hand, recommends a screening every one to two years. And it made that recommendation in March after overruling a panel that concluded such frequent routine screening wasn't necessary, sparking a public outcry.

Writing in the Annals of Internal Medicine, Dr. David Ransohoff and Dr. Russell Harris of the University of North Carolina School of Medicine said the debate has become so contentious that "the discourse that might find common ground is not occurring."

"With emotional outbursts at public meetings and in the press, positions seem to have hardened," they wrote.

Health officials say the atmosphere is now so charged that researchers are afraid to conduct medical trials which could compare the effectiveness of mammograms in different age groups.

Medical Correspondent Rhonda Rowland and Reuters contributed to this report.

 
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