The National Medical Association, the nation’s oldest and largest group representing Black doctors, warns that the 2009 U.S. Preventive Services Task Force’s revised recommendations on breast cancer screenings could have serious implications for African-American women. In an official statement, NMA president Willarda V. Edwards, M.D., said African-American women, in consultation with their physician, should continue the practice of routine mammography screening at age 40 or earlier depending upon the risk factors.
“The NMA is concerned about the USPSTF recommendations that women have routine mammography screenings beginning at age 50 instead of 40. The new recommendations could have serious implications for African American women since studies have shown that African American women develop breast cancer at an earlier age, are often diagnosed at a later stage of the disease, and develop more aggressive types of breast cancer,” Dr. Edwards said. “The USPSTF recommendations could result in even higher death rates for this disease and further exacerbate the challenges for the uninsured and the under insured.”
The American College of Obstetricians and Gynecologists also maintains that women in their 40s continue mammography screening every one to two years and women age 50 or older continue annual screening.
The task force’s revised recommendations, published in the Nov. 17 issue of Annals of Internal Medicine, updates the “2002 Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement.” The update recommends against routine screening mammography in women aged 40 to 49 years, advising that the decision to start regular, biennial screening mammography before the age of 50 “should be an individual one and take into account patient context, including the patient’s values regarding specific benefits and harms.”
The update also recommends biennial screening mammography for women between the ages of 50 and 74 years. It concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older, as well as the additional benefits and harms of clinical breast examination beyond screening mammography in women 40 years or older. It also recommends against clinicians teaching women how to perform breast self-examination.
However, the NMA says it “strongly recommends” clinical breast exams, self-breast examinations, mammography and all other emerging technologies as important tools in prevention. “The health care community has spent the last two decades promoting screenings and early detection. We do not want all of the progress that has been made in promoting screenings to be lost. The current screening guidelines while not perfect, they do save lives,” Dr. Edwards said.
Founded in 1895, the National Medical Association represents more than 30,000 African-American physicians and their patients, advocating for policies that would assure equitable and quality health care for all people.