Screening Mammography for Women Aged 40 to 49: Update

In Québec, breast cancer is the leading cancer in women and the second most common cause of cancer-related mortality, after lung cancer. It affects roughly 6000 women in Québec each year. It is well established that mammographic screening helps reduce mortality from breast cancer in women aged 50 to 69 years. Since 1998 Québec’s breast-cancer screening program, the Programme québécois de dépistage du cancer du sein (PQDCS), has offered screening to all women in this age group through a screening test every two years.

Recent evidence indicates that annual screening for women aged 40 to 49 years may be effective in reducing mortality from breast cancer, although less so than for women aged 50 to 69 years. In that context, AETMIS was asked to examine the possibility of offering women the opportunity to take part in a systematic mammographic screening program starting at the age of 40.

Although screening mammography helps reduce mortality to some extent, it also has some drawbacks for women aged 40 to 49 years.

The breasts of pre-menopausal women are generally denser than those of women past menopause, which makes mammography films more difficult to interpret. This examination must be performed every year, and additional tests (repeat mammograms; biopsies; etc.) are more frequent than for women aged 50 and older. Younger women are also exposed to higher radiation doses, which is a risk in itself. Given that breast cancer is less common in younger women, these drawbacks significantly counterbalance the benefits they could gain from participating in a systematic screening program.

In light of those benefits and drawbacks, AETMIS considers that it is not advisable to extend the screening program to all women aged 40 to 49 years. Currently, doctors can recommend mammographic screening to some women in that age group after assessment of their individual risk. AETMIS believes that this avenue should be pursued. Lastly, AETMIS has made other recommendations on the organization of the PQDCS and on ways to strengthen its quality-assurance measures in order to optimize the services offered to women.

Screening Mammography for Women Aged 40 to 49: Update

	2009_08_res_en.pdf | English summary | 450,8 KB
	ETMIS2009_Vol.5_No8.pdf | French report | 1,5 MB
	Information_document.pdf | English information document | 136,3 KB
	2009_08_res_fr.pdf | French summary | 592,6 KB
	Document _information grand public.pdf | French information document | 147,4 KB

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AETMIS takes full responsbility for the final form and content of its reports. The conclusions and recommendations therein do not necessarily reflect the views of the external reviewers or of any other person consulted in the context of a study.