Mammograms have helped to lower death rates from breast cancer, but a new report by the Institute of Medicine suggest a lot more needs to be done to improve breast cancer screening and save even more lives.
The report says that increasing the number of women who get mammograms and making the tests more accurate should be top priorities.
The American Cancer Society recommends that women should start mammograms at the age 40. Many women fail to get screened regularly and some simply don't get screened at all, the IOM report noted. In some cases lack of health insurance prevented screening while in other cases fear of the disease or even the mammogram itself put many women off screening. The report also cited the lack of reminder systems as a major factor in women not being screened.
In many cases, women simply lack adequate access to screening facilities and doctors. Today fewer radiologists specialize in mammography and screening facilities across the country are closing down. This has led to waiting lists of up to 5 months for a mammogram in some parts of the U.S.
The accuracy of mammograms also comes into question. Mammograms are the best screening method currently available, but still miss up to 17% of tumors and return a false-positive result 10% of the time. Reducing the number of false-positive results could save up to $100 million every year, the report said.
The report suggests that European style screening programs should be followed in the U.S. with the adoption of national certification standards for radiologists, as is done in Britain. Mammograms could also be sent to a handful of specialized centers where highly trained specialists could examine them for abnormalities. This technique has helped cut the rate of false-positive readings in Sweden and the Netherlands.
The report goes on to suggest that by creating a new type of health care specialist who is not a doctor, but who is trained to read mammograms would lower the rate of false-positive screenings.
New screening technologies should also be introduced to reduce the death rate from breast cancer, the report said. It called for greater collaboration among researchers, funding agencies, insurers, and doctors so that new technologies for detecting breast cancer can be developed, tested and put to use faster.
Researchers must also continue to refine their understanding of breast cancer risk factors, the report said, so that screening recommendations can be tailored to individual women. Genomic and proteomic tests or other biomarkers are technologies that will one day offer great potential but these technologies are still very much in their infancy.
Overall a better understanding of breast cancer risk would help women make better choices about screening and other lifestyle factors that could influence breast cancer risk.