ROANOKE TIMES
Copyright (c) 1997, Roanoke Times
DATE: Monday, March 24, 1997 TAG: 9703240152
SECTION: NATIONAL/INTERNATIONAL PAGE: A-1 EDITION: METRO
DATELINE: RESTON, VA.
SOURCE: ASSOCIATED PRESS
The National Cancer Institute is expected to follow suit. Critics of the earlier advice say waiting until 50 to look for breast cancer is unreasonable.
The American Cancer Society recommended Sunday that women begin annual mammograms at age 40, and the National Cancer Institute may reverse itself soon and adopt similar guidelines.
Until now, the cancer society has urged mammograms every year or two for women in their 40s. The changed recommendation is intended to save lives and simplify the confusion surrounding mammography guidelines, Dr. Myles Cunningham, the society's president, said Sunday.
``We think women need specific guidance, and if there is a benefit, we should say so,'' Cunningham said.
Mammograms for younger women have become one of the most contentious issues in medicine, especially since the federal cancer institute said two months ago it could not make sweeping recommendations for women under 50.
Since then, the institute has been under pressure from Congress to do just that, and it now appears to be on the verge of recommending mammograms for all women in their 40s.
The society's board of directors adopted the new guideline Saturday and announced the change Sunday at a science writers' conference sponsored by the cancer society.
The debate over mammograms centers on whether they truly save younger women's lives and whether the high number of false alarms they trigger is justified. Experts say only about 15 percent of ominous results from mammograms of women in their 40s actually prove to be cancer.
Virtually all health professionals agree that annual mammograms make sense for women over 50. Most also agree that mammograms are unnecessary for women in their 30s.
It's unclear how helpful they are for women in their 40s. At this age, breast cancer is relatively rare: About 1.5 percent of U.S. women will get breast cancer between 40 and 49.
In January, a panel of experts assembled by the National Cancer Institute looked at all the studies and concluded the evidence of benefit was too slim to recommend annual screening. Instead, it said ``each woman should decide for herself'' whether to start having mammograms during her 40s.
The cancer society has been one of the foremost critics of that conclusion. Two weeks ago, at a workshop to look at the same data, its experts recommended annual mammograms start at 40.
The National Cancer Advisory Board, a presidentially appointed committee that advises the National Cancer Institute on policy, is expected to issue its recommendations Wednesday.
Dr. Harmon Eyre, a cancer society executive vice president, said he was told by National Cancer Institute Director Richard Klausner that the new federal guidelines will be similar to the one just discarded by the cancer society: that all women in their 40s have mammograms every year or two.
Dr. Daniel Kopens of Massachusetts General Hospital, a critic of the earlier conclusion, said arbitrarily waiting until age 50 to look for breast cancer is unreasonable.
He and other supporters of earlier screening say the biology of the breast changes only gradually between ages 40 and 60.
``Starting screening at age 40 makes all kinds of sense in terms of both the biology and the genetics'' of breast cancer, said Mary-Claire King, a breast cancer geneticist from the University of Washington.
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