Tipping the Balance of Benefits and Harms to Favor Screening Mammography Starting at Age 40 Years

TL;DRAbstract

The US Preventive Services Task Force recommends biennial breast cancer mammography screening for women aged 50 to 74 years. A large body of evidence has shown a favorable balance of benefits and harms for screening in this age group. All current guidelines support this recommendation. However, the US Preventive Services Task Force did not recommend routine screening before age 50 based on the high false-positive rate in younger women. A strategy focused on screening only the younger women at greatest risk of breast cancer would address concerns over the high ratio of harm to benefit. The aim of this comparative modeling study was to determine the threshold relative risk (RR) at which the harm-benefit ratio of starting screening women aged 40 to 49 years equals that of biennial screening for average-risk women aged 50 to 74 years. The effect of screening method (film, digital) and screening interval (annual, biennial) on the threshold RR was also evaluated. Data from the Surveillance,

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