Nov 15, 2018
Revised mammogram guidelines, competing headlines and providers who offer varying recommendations have left many women wondering how to best manage their breast health. Cedars-Sinai surgical oncologist and breast cancer risk-assessment specialist Nimmi Kapoor, MD, clears up the confusion.
The Current Guidelines
The American Cancer Society changed guidelines for mammograms in 2015 to recommend that women start the scans annually no later than age 45. After age 55, some women can switch to getting tested every other year. The guidelines reflect concern that earlier screening can lead to false positives, anxiety, unnecessary tests and overtreatment of cancers that would never become life-threatening.
Starting at 45 Is OK, but 40 Is Safer
“Studies show that starting screening at 40 prevents deaths,” Kapoor says. “Don’t be scared of finding something alarming. Instead, work with your doctor to make sure you’re not overtreated.” Less invasive measures can be tailored to fit women who aren’t at high risk for an aggressive form of cancer.
Cancer Risk Is Personal
“There is no such thing as one size fits all,” Kapoor says. Factors from age and ethnicity to hormone usage and menstrual history all impact a woman’s odds of getting breast cancer. “We have computer programs that sort out dozens of factors to calculate risk,” she says. Understanding your personal risk will help guide decisions about the best screening plan for you.
Additional American Cancer Society screening guidelines for those at average risk:
Colon and Rectal Cancer
WHAT? Stool-based test or a colonoscopy
WHEN? Start at age 45 and continue through at least age 75.
WHAT? Pap and HPV tests
Age 21–29: Pap every 3 years
Age 30–65: Pap and HPV every 5 years
Age 65+: If cervical-cancer tests have been normal for 10 years, no more testing is needed.
WHAT? Prostate-specific antigen (PSA) blood test with or without a rectal exam
WHEN? It depends. Talk to a healthcare provider about the pros and cons of starting at age 50 (45 for African-Americans). Frequency depends on PSA levels.