Starting mammography at the age of 40 narrows the mortality gap among black women.

Jeanne S. Mandelblatt, MD, MPH is a senior author of “Identifying a Fair Screening Mammography Strategy for Black Women in the United States Using Simulation Modeling.”Credit: Georgetown University

Analysis performed by a modeling team that is part of the Cancer Intervention and Surveillance Modeling Network shows that when black women start mammography screening every other year from the age of 40, breast cancer deaths compare to those who start screening 10 years later. And can be reduced by 57%. CISNET), funded by the National Cancer Institute.

Analysis is the first to use modeling to unravel the modern era chest cancer A screening strategy that best achieves fairness in screening results and reduces mortality disparities. A study published on October 19, 2021 Annual report of internal medicine, Suggests that reductions in black breast cancer mortality can be achieved woman While maintaining the ratio of profit to harm Caucasian woman Screened every other year from the age of 50. The recommendations of the last two decades do not explain the role of racism (structural, interpersonal, or internalization) and its implications. Breast cancer treatment, Survival and death of black women.

“There is an increasing focus on eliminating race-based medicine,” explains Christina Hunter Chapman, MD, a part-time assistant professor at the University of Michigan’s Department of Radiation Oncology, who is the lead author of the study. “But a call to end racial care for the immediate termination of racial debate is unlikely to close racial inequalities. Carefully selected solutions for health inequalities are: May include interventions tailored to specific racial groups. “

To address this issue, CISNET has developed a model that uses self-reported races on behalf of those who are likely to experience the effects of racism to test various screening strategies. .. The model also considered breast density, distribution of breast cancer molecular subtypes, age, stage, and subtype-specific therapeutic effects, and black and white non-breast cancer mortality. Using all these data, the model compared the benefits and harms of different screening strategies for black women to those of white women screened every other year from the age of 50-74.

“For black women, three biennial screening strategies (starting at age 40, 45, or 50) provided a higher percentage of benefit-harm than that found in white women who started screening at age 50.” Explains Chapman. “Of these three strategies, starting mammograms at age 40 reduced mortality to the maximum and reduced the black-and-white mortality gap by 57%. This approach US Preventive Medicine Committee Comprehensive guidance if a woman wants to consider starting biennial mammography. “

The model used by the researchers predicted the lifelong impact of digital mammography on different screening intervals and starting ages for women who will be 40 years old in 2020 (that is, born in the United States in 1980). High numbers of mammograms (eg, annual and biennial screening), false positives for a variety of benefits (early lifespan from early detection of cancer, avoidance of breast cancer mortality, reduced mortality) Compared with harm such as. Screening results.

“Black women have a higher incidence of aggressive cancer at a younger age than white women, and treatment of these types of tumors is less effective. However, even considering the cancer subtypes, the mortality rate is Black woman Primarily due to factors rooted in racism, “said Jeanne S. Mandelbratt, lead author of the study, professor of oncology and medicine at the Georgetown Lombardi Comprehensive Cancer Center and principal investigator of CISNET. The doctor of medicine says.

“Therefore, our analysis explained the differences in treatment due to racism, including access to medications, delays in treatment, weight loss, discontinuation of treatment, etc. All of these. Factors are often shown to be less optimal in black than in white. Women, “she added.

“We hope this will develop equitable recommendations for black women and provide new information to help address the long-standing lack of breast cancer screening guidelines due to lack of data,” Mandel said. Bratt says.

“In the future, the harm of racism in medicine may be better corrected by developing interventions that use more direct means of racism instead of racism,” Chapman said. Concludes. “However, Socioeconomic status Given that racial disparities in breast cancer have been observed across the socio-economic demographic, doing it alone as a racial substitute is not appropriate for studies like ours. “

“This project highlights how CISNET modeling can provide important new data to a group of guidelines that seek to increase the fairness of cancer outcomes,” said the National Cancer Institute for Breast and Gynecologic Cancer. Dr. Brandy Heckman-Stoddard, Chief of the Research Group, said. “It also shows the need to keep capturing data. Sifting Practices across diverse groups. ”

Researchers are developing breast cancer prediction tools for black women

For more information:
Christina Hunter Chapman et al, Identifying Fair Screening Mammography Strategies for Black Women in the United States Using Simulation Modeling, Annual report of internal medicine (2021). DOI: 10.7326 / M20-6506

Quote: When starting mammography at the age of 40, a black woman obtained on October 19, 2021 from https: // (2021) The mortality gap (October 19) will be reduced.

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Starting mammography at the age of 40 narrows the mortality gap among black women.

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