Mammography in Older Women and Life Expectancy

It is still unknown if regular screening mammography would benefit women aged 65 and older, according to a study published in the Journal of General Internal Medicine.

Researchers from the University of California, San Francisco; the San Francisco VA Medical Center; and the University of California, Berkeley, conducted a systematic review to assess the quality and limitations of published studies examining benefits and harms of screening mammography in relation to comorbidity and age.

The researchers reviewed studies published between January 1980 and June 2013 that examined the benefits or harms of screening mammography among older women, in relation to comorbidity. Using data regarding setting, design, quality, screening schedule, measure of comorbidity, and estimates of benefits and/or harms, they identified seven articles out of 1,760 titles that met their criteria:[[{"type":"media","view_mode":"media_crop","fid":"46123","attributes":{"alt":"mammography","class":"media-image media-image-right","id":"media_crop_5346761876178","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"5332","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 120px; width: 180px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"©zlikovec/Shutterstock.com","typeof":"foaf:Image"}}]]

• Two prospective cohort studies

• Two retrospective cohort studies

• Three decision analyses studies

The researchers did not identify any suitable randomized controlled trials.

The results found that four studies examined at least one measure of life expectancy or reduction in the risk of breast cancer death as a marker of benefit and three studies addressed the harms of screening mammography, including false-positive results. “Both cohort studies and decision analyses showed that screening benefits decreased with increasing age and comorbidity burden,” the authors wrote.

There is still limited evidence that suggest that women over the age of 65 without severe comorbidity would see any improvements to life expectancy as a result of routine mammography screening. “Given the potential for harm, it is unclear whether the magnitude of the benefit is sufficient to warrant regular screening,” the authors concluded. “Women, clinicians and policymakers should consider these factors in deciding whether continue screening.”