ACR Backs ROOT Act to Reignite AUC Program Implementation
ACR urges Congress to pass the legislation to promote value-based care, help Americans avoid unwarranted exposure and reduce Medicare spending.
Read moreA recent editorial relies on obsolete, hyperbolic information. Most experts do not support1 the delayed or less frequent breast cancer screening the article advocates.
The American College of Radiology® (ACR®) urges women to start annual screening at age 402 and to have a breast cancer risk assessment3 by age 25. The United States Preventive Services Task Force (USPSTF), American Cancer Society, ACR and Society of Breast Imaging agree that the most lives and years of life are saved by starting annual screening at age 404.
National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results5 data show that, since screening became widespread in the 1980s, the U.S. breast cancer death rate in women has dropped 40%. Women screened regularly have a 47% lower risk of breast cancer death6 within 20 years of diagnosis than those not regularly screened. Regular mammography use cuts the risk of breast cancer death nearly in half7,8.
NCI/Cancer Intervention and Surveillance Modeling Network models show a major decline9 in deaths in women screened annually vs. biennially. Swedish data shows10 chemotherapy is much more effective in screened women11 vs. unscreened women.
Total reliance on outdated randomized controlled trials (RCT) to inform screening policy can cost lives. The most recent RCT started over 30 years ago12. The first RCT is more than 60 years old13. All used outdated, film-screen technology, many obtained only single views of each breast and there were limited screening rounds with variable screening intervals. Today, digital mammography with tomosynthesis, which acquires dozens of views of each breast, has increased cancer detection, and a decrease in callbacks and false positives is standard.
The RCTs individually did not have adequate statistical power to evaluate breast cancer mortality benefit for women in their 40s; however, subsequent meta-analyses have shown clear mortality benefit of screening in women ages 40–4914,15,16.
Screening risks — which are non-lethal — are overstated17 due to faulty assumptions, methodology and hyperbole in articles on which these claims are based. High overdiagnosis claims are not well-founded17. Such claims based on modeling studies are inflated18. Well-designed studies provide an overall breast cancer overdiagnosis estimate of 10% or less19,20,21. Screening-detected breast cancers do not disappear or regress if left untreated22.
So-called false positive exams (recalls from screening) are usually resolved by the woman coming back to get additional mammographic views, ultrasound or MRI. Anxiety from an inconclusive mammogram result or false positive is brief, with no lasting health effects23. Nearly all women who have had a false positive exam still endorse regular screening24.
Foregoing or delaying screening — resulting in breast cancer not being discovered until at an advanced stage — is often lethal. Screening only women ages 50–74 every other year may result in up to 10,000 additional, and unnecessary, breast cancer deaths25 in the United States each year. Thousands more would likely endure extensive surgery, mastectomies and chemotherapy for advanced cancers.
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ACR Backs ROOT Act to Reignite AUC Program Implementation
ACR urges Congress to pass the legislation to promote value-based care, help Americans avoid unwarranted exposure and reduce Medicare spending.
Read moreShort-Term Resolution to Fund Government
Before leaving Washington, DC, for the holidays, Congress passed a continuing resolution (CR), to fund the federal government until March. The CR also includes a farm bill extension, disaster aid and several healthcare provisions.
Read moreACR Calls For Congressional Action to Pass Medicare Patient Access and Practice Stabilization Act
Before it adjourns at the end of the year, Congress must act on this bill to increase the conversion factor and help ensure that radiology practices and all healthcare providers can continue to offer high-quality care.
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