(Press-News.org) Doctors should focus on life expectancy when deciding whether to order mammograms for their oldest female patients, since the harms of screening likely outweigh the benefits unless women are expected to live at least another decade, according to a review of the scientific literature by experts at UCSF and Harvard medical schools.
National guidelines recommend that doctors make individualized screening decisions for women 75 and older. But the analysis, published online Tuesday in JAMA (March 31, 2014), concluded that since this age group was not included in mammography trials, there is no evidence that screening helps them live longer, healthier lives.
The authors said that many women in this age group receive regular mammograms anyway, with no discussion about the uncertain benefit or potential harms of continued testing, which include unnecessary treatment for slow-growing cancers or pre-cancerous lesions that pose no real threat to the women's lives.
They concluded that women who are expected to live a decade or more should talk with their doctors and weigh the potential benefits of diagnosing a dangerous but treatable cancer through mammography against the possibility of being misdiagnosed or treated aggressively for a cancer that posed no real harm.
"People should be informed that everything we do in medicine can have good and bad effects, and that goes for mammography," said Louise Walter, MD, UCSF professor of medicine and chief of the Division of Geriatrics.
The authors arrived at their conclusions after examining all the studies conducted from 1990 to 2014 that identified risk factors for late-life breast cancer in women 65 and older, as well as the studies that assessed the value of mammography for women 75 and older.
Since there were no randomized trials of the benefits of screening women over 74, they could not say whether mammography was beneficial for those women. Longitudinal studies found that healthy older women who were screened with mammography were less likely to die from breast cancer, but screening was not beneficial for women with serious medical problems.
Modeling studies indicate mammograms would prevent two cancer deaths for every 1,000 women in their 70s who were screened every two years for 10 years. However, these studies also predicted that about 200 of those women would receive test results indicating they had cancer when they did not, and about 13 would be treated for cancers that posed no harm.
Doctors use complex algorithms to assess breast cancer risk, but these calculations lose their ability to predict disease in the oldest women, because risk factors change as women age.
For example, how old a woman was when she first got her period and whether she bore children and at what age are important factors in determining breast cancer risk for women under 75. But these factors are no longer relevant once women reach the age of 75. Instead, the main risk factor for developing breast cancer is age itself.
"The things that may be predictive in older women likely have to do with recent hormone exposure, such as lifelong obesity, high bone density or taking hormones, which are associated with higher estrogen levels," said Mara Schonberg, MD, MPH, an assistant professor of medicine at Harvard Medical School. "Distant hormone exposures, such as the age a woman first got her period, may not make much difference in who gets breast cancer in this older population. Older age is the greatest risk factor for breast cancer."
INFORMATION:
UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy, a graduate division with nationally renowned programs in basic biomedical, translational and population sciences, as well as a preeminent biomedical research enterprise and two top-ranked hospitals, UCSF Medical Center and UCSF Benioff Children's Hospital.
Experts question routine mammograms in elderly
UCSF-Harvard study finds tests offer limited benefit to oldest female patients
2014-04-01
ELSE PRESS RELEASES FROM THIS DATE:
Night owls, unlike early birds, tend to be unmarried risk-takers
2014-04-01
Women who are night owls share the same high propensity for risk-taking as men, according to a recent study by a University of Chicago professor.
The research suggests that sleep patterns are linked with important character traits and behavior, said study author Dario Maestripieri, professor in Comparative Human Development. Night owls—people who tend to stay up late and wake up late in the morning—are different in many important ways from early risers, he found.
"Night owls, both males and females, are more likely to be single or in short-term romantic relationships ...
Like hand-washing, blood transfusions linked to infections
2014-04-01
Blood transfusions are among the most common treatments for hospitalized patients nationwide, but doing them less often reduces infection rates by nearly 20 percent, according to a study in the Journal of the American Medical Association co-authored by Neil Blumberg, M.D., professor at the University of Rochester School of Medicine and Dentistry.
As director of transfusion medicine and the blood bank at UR Medicine, Blumberg for more than 25 years has been investigating how to make blood transfusions safer. The JAMA study is the first to show conclusively, through a study ...
A protein could be a key weapon in the battle of the bulge
2014-04-01
Bethesda, MD (April 1, 2014)— More than one-third of people in the US are obese. Obesity and its related health problems—including high blood pressure, high cholesterol, diabetes, insulin resistance, and belly fat—affect so many, yet effective treatments are very few. In a new study, Simon Musyoka Mwangi and colleagues tested whether higher levels of a certain protein help fight the weight gain and health problems caused by eating the wrong foods.
Glial cell line-derived neurotrophic factor—or GDNF for short—is a protein integral to keeping the body's systems in balance ...
Adult tonsillectomy complications and health care expenses
2014-04-01
A study released today of 36,210 adult tonsillectomy patients finds that 20 percent will have a complication, offering valuable new insights to a decades long discussion. The study, featured in the April 2014 issue of Otolaryngology—Head and Neck Surgery, examines the prevalence of complications in adult tonsillectomies and the impact on health care expenditures.
"Researchers have been examining variation in tonsillectomy for years," explained corresponding author, Dennis Scanlon, PhD. "Yet most research has been documented in pediatric populations. Much less is known ...
Deforestation of sandy soils a greater climate threat
2014-04-01
Deforestation may have far greater consequences for climate change in some soils than in others, according to new research led by Yale University scientists — a finding that could provide critical insights into which ecosystems must be managed with extra care because they are vulnerable to biodiversity loss and which ecosystems are more resilient to widespread tree removal.
In a comprehensive analysis of soil collected from 11 distinct U.S. regions, from Hawaii to northern Alaska, researchers found that the extent to which deforestation disturbs underground microbial ...
Researchers identify similarities between HIV/AIDS and opioid addiction epidemics
2014-04-01
(PROVIDENCE, R.I.) – There are important parallels between the early years of the HIV/AIDS epidemic and the current epidemic of opioid addiction - ones that could trigger a significant shift in opioid addiction prevention, diagnosis and treatment.
These are the findings of a comparative review of HIV/AIDS and addiction by researchers Josiah D. Rich, M.D., M.P.H., director of the Center for Prisoner Health and Human Rights, based at The Miriam Hospital; Traci C. Green, Ph.D., MSc, Department of Emergency Medicine at Rhode Island Hospital and assistant professor of Emergency ...
Study reveals animal research bias in experimentation oversight committee membership
2014-04-01
Denver — Committees that are federally mandated to review, approve, and monitor the use of animals in experiments—called Institutional Animal Care and Use Committees (IACUC)—are dominated by animal research interests, according to a study presented today (Wednesday April 2) at the 2014 Public Responsibility in Medicine and Research (PRIM&R) IACUC Conference in Denver.
Using the federal Freedom of Information Act, researchers from People for the Ethical Treatment of Animals (PETA) and the University of California–San Diego School of Medicine obtained the current IACUC ...
Fruitfly study: Epilepsy drug target implications for sleep disruption in brain disorders
2014-04-01
PHILADELPHIA — A new study in a mutant fruitfly called sleepless (sss) confirmed that the enzyme GABA transaminase, which is the target of some epilepsy drugs, contributes to sleep loss. The findings, published online in Molecular Psychiatry, were led by Amita Sehgal, PhD, head of the Chronobiology Program at the University of Pennsylvania's Perelman School of Medicine. The findings shed light on mechanisms that may be shared between sleep disruption and some neurological disorders. A better understanding of this connection could enable treatments that target both types ...
ED dental care treatment raises access, cost issues for policymakers, Rutgers study finds
2014-04-01
NEW BRUNSWICK, N.J. – The use of emergency departments for dental care – especially by young adults in low-income communities – is presenting policymakers with a challenge, according to a Rutgers report which offers several remedies including expanding hours at the dentist's office.
"Emergency departments are poorly equipped to deal definitively with dental and oral health needs," said Kristen Lloyd, senior analyst at Rutgers' Center for State Health Policy and lead author of the report. "Still, many people seek care in emergency departments for nontraumatic dental ...
Schools have limited success in reducing bullying, new analysis finds
2014-04-01
Two UCLA professors who conducted the most thorough analysis to date of studies on school bullying have found that K-12 schools' efforts to curtail bullying are often disappointing.
The study revealed that schools are trying many different approaches to protect students, and while the more comprehensive programs have been the most effective, they require substantial commitment and school resources to be successful.
"Band-Aid solutions, such as holding one assembly a year that discourages bullying, do not work," said Jaana Juvonen, a UCLA professor of psychology ...
LAST 30 PRESS RELEASES:
Making a difference: Efficient water harvesting from air possible
World’s most common heart valve disease linked to insulin resistance in large national study
Study unravels another piece of the puzzle in how cancer cells may be targeted by the immune system
Long-sought structure of powerful anticancer natural product solved by integrated approach
World’s oldest lizard wins fossil fight
Simple secret to living a longer life
Same plant, different tactic: Habitat determines response to climate
Drinking plenty of water may actually be good for you
Men at high risk of cardiovascular disease face brain health decline 10 years earlier than women
Irregular sleep-wake cycle linked to heightened risk of major cardiovascular events
Depression can cause period pain, new study suggests
Wistar Institute scientists identify important factor in neural development
New imaging platform developed by Rice researchers revolutionizes 3D visualization of cellular structures
To catch financial rats, a better mousetrap
Mapping the world's climate danger zones
Emory heart team implants new blood-pumping device for first time in U.S.
Congenital heart defects caused by problems with placenta
Schlechter named Cancer Moonshot Scholar
Two-way water transfers can ensure reliability, save money for urban and agricultural users during drought in Western U.S., new study shows
New issue of advances in dental research explores the role of women in dental, clinical, and translational research
Team unlocks new insights on pulsar signals
Great apes visually track subject-object relationships like humans do
Recovery of testing for heart disease risk factors post-COVID remains patchy
Final data and undiscovered images from NASA’s NEOWISE
Nucleoporin93: A silent protector in vascular health
Can we avert the looming food crisis of climate change?
Alcohol use and antiobesity medication treatment
Study reveals cause of common cancer immunotherapy side effect
New era in amphibian biology
Harbor service, VAST Data provide boost for NCSA systems
[Press-News.org] Experts question routine mammograms in elderlyUCSF-Harvard study finds tests offer limited benefit to oldest female patients