Studies split on mammogram's usefulness for younger women
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
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
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
Medical Correspondent Rhonda Rowland and Reuters contributed to this report.