75 years is an appropriate upper age limit for mammography

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NEW YORK (Reuters Health), May 17 - Results of a study published in the April issue of the International Journal of Cancer suggest that 75 years of age is an appropriate upper limit for population-based mammography screening.

Dr. Jacques Fracheboud, of University Medical Center Rotterdam, the Netherlands, and colleagues used data from the Dutch breast cancer screening program for women to examine the current upper age limit of women invited to participate. Main outcome parameters of the screening program 1998 to 2000 were compared between women ages 70 to 75 years and those ages 50 to 69 years.

Overall, 2.8 million women were invited between 1998 and 2000. Of these, 78.7% attended the screening program. Patients in all age groups had lower attendance in the initial screening than in subsequent screenings. Women between the ages of 70 and 75 years had lower but substantial attendance (67.3%) at subsequent screenings. There was a marked increase in the attendance rate of women ages 70 to 75 years between 1998 and 2000. For women ages 74 to 75 years, the absolute increase was nearly 10%.

A total of 187,207 screening examinations were performed in women ages 70 to 75 years. The overall detection rate in this group was 10.3 per 1000 women screened. Detection rates in both first and subsequent screenings increased with age.

A "major finding" of the study is that elderly women have a high rate of screening participation, the investigators conclude.

Also, "The outcomes of our study suggest a steadily increasing sojourn time of breast tumors beyond the age of 69, leading to a strong increase in detection of cancers," Dr. Fracheboud's team writes. Sojourn time is "the time in which a cancer is still asymptomatic but already detectable by a screening test."

Because of these findings, "further increasing the upper age limit, for instance up to 80 years, would then lead to a considerable extra incidence and overtreatment of breast cancers," the authors note.

"At present, 75 years of age can be regarded as an appropriate upper age limit for the Dutch programme," they conclude.

Last Updated: 2006-05-17 13:36:42 -0400 (Reuters Health)

Int J Cancer 2006;118:2020-2025.

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