Black women should be screened for breast cancer eight years earlier than guidelines recommend, new research suggests.
Published Wednesday in JAMA Network Open, the study explored whether age 50 was actually the best time to start getting mammograms.
The international team of researchers found that black women have a disproportionately higher risk of dying from breast cancer, so they advise this demographic to start getting screened for breast cancer at age 42.
“The current one-size-fits-all policy for testing the entire female population above a certain age may not be fair, equitable, or optimal,” the study authors wrote.
The current guidance, established by the US Preventive Services Task Force, is based on the risk of developing breast cancer, the second leading cause of cancer death in American women.
Women ages 40 to 49 are encouraged to discuss their options with their doctor and develop an individualized plan.
Breast cancer is the most diagnosed cancer
among black women, with the American Cancer Society predicting 36,260 new cases in 2022.
Black women have the highest death rate from breast cancer and have nearly three times the risk of being diagnosed with a fast-growing, invasive type of cancer called triple-negative breast cancer.
The new study analyzed data from more than 415,000 American women who died of breast cancer between 2011 and 2020, grouping patients by race and ethnicity.
The researchers found that for every 100,000 black women age 40, there were 27 deaths. In the same number of white women in their 40s, there were 15 deaths.
They advised that black women be tested at age 42, while the same risk for white women does not reach until age 51. American Indian, Alaska Native and Hispanic women could be tested at 57, while Asian and Pacific Islander women could wait until 61.
“This can be an important step towards a more streamlined, equitable and personalized system. [breast cancer] detection and can help mitigate the current disparity of long standing early start [breast cancer] mortality in populations, especially black women, at higher risk,” the study authors wrote.
Experts believe that implicit bias in the medical industry prevents black women from receiving adequate care compared to their white counterparts.
“There are systemic issues, care access issues that really go beyond biology,” Dr. Arif Kamal, chief patient officer for the American Cancer Society, told CNN.
“The reality is that cancer affects everyone and does not discriminate. Where discrimination sometimes happens is after diagnosis, and that’s really what we need to focus on.”
Dr. Rachel Freedman, a breast oncologist at the Dana-Farber Cancer Institute who was not involved in the study, told the outlet that while the current guidelines do take cancer risk into account, “race and ethnicity There have not been traditional factors involved in these decisions. .”
“This study confirms that the age of mortality from breast cancer is younger for black women, but it does not confirm why and whether screening is even the main reason,” she added, pointing to the lack of access to screening history for black women. patients. .
“We don’t have information about the types of cancers the women developed and what treatment they received, as both affect breast cancer mortality.”
While screening tests can detect breast cancer earlier, saving lives, the Centers for Disease Control and Prevention also warns of risks, including overdiagnosis, overtreatment, and radiation exposure.
The agency named false positives as potential harm, which not only cause patient stress but also result in further testing that can be invasive and expensive.
“While some may argue that earlier screening tests can lead to more recalls and unnecessary biopsies, women are recalled for additional imaging about 10% of the time and biopsies are needed in 1-2% of cases, which is pretty low,” Dr. Kathie said. -Ann Joseph, a surgical oncologist at the Perlmutter Cancer Center at NYU Langone, told CNN.
“This has to be compared to the lives saved from previous screening mammography,” the professor of surgery and population health continued. “I’d also like to point out that while we want to prevent deaths, early detection may have other benefits by allowing women of all racial and ethnic groups to have less extensive surgeries and less chemotherapy, which impacts quality of life.”
