BfS: mammography screening programme also beneficial for younger women

Mammography findings Source: Gorodenkoff/Stock.adobe.com

Participation in the mammography screening programme is also associated with more benefits than risks for women aged 45 and over. That is the conclusion reached by the Federal Office for Radiation Protection (BfS) in its scientific report on "Early detection of breast cancer using X-ray mammography in women under 50". The BfS recommends reducing the lower age limit for participation in the programme from 50 to 45. Until now, women between the ages of 50 and 69 have been eligible for regular X-ray examinations aimed at the early detection of breast cancer. The new publication has been published in the Federal Gazette and on the BfS website.

"The report shows that mammography screening can also reduce breast cancer mortality in younger women. It also proves that the associated radiation risk is relatively low. This justifies the BfS’s current recommendation that women should be allowed to participate from the age of 45", says BfS President Inge Paulini.

Dr Inge Paulini

Extension of age limits for women in Germany and Europe

The BfS report provides the scientific basis for the Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection (BMUV) to authorise the early detection of breast cancer using X-ray mammography in women from their mid-40s onwards in the form of a statutory order. It is for the Federal Joint Committee (G-BA) to decide whether this age group's participation in the mammography screening programme is financed by the statutory health insurance funds.

The BfS had already examined and approved an extension of the age limit to 75 years in 2022. Women in this age group are expected to be able to take part in screening from mid 2024. The extension of the age limits is also recommended in the new version of the European breast cancer guidelines.

Comprehensive information is essential Source: Siphosethu F/peopleimages.com/Stock.adobe.com

Benefits and risks of early detection using X-rays

Breast cancer is the most common form of cancer in women. In Germany, some 5,000 women between the ages of 45 and 50 are diagnosed with breast cancer every year. For the report on this age group, the BfS analysed publications on eight studies, from four countries, that meet high scientific standards. The analysis included data from around 370,000 women aged 39 to 49 who were recruited for mammography screening studies between 1963 and 1994. The meta-analysis concludes that screening can reduce breast cancer mortality in the younger group to a similar extent as in the 50–69 age group, i.e. by around 20%.

Risk-benefit analysis is particularly important when evaluating a screening programme. This is because only people with the disease benefit from taking part in screening, whereas the risk – from X-ray radiation, for example – is borne equally by all participants.

Although participation in screening from the age of 45 would be associated with a higher radiation-related risk than participation from the age of 50, the report estimates the overall radiation risk as low compared to the benefits. From a radiation protection perspective, participation in the quality-assured mammography screening programme would therefore be justified from the age of 45. The two-year interval for participation should also be maintained in this age group. The report emphasises that it is essential that women be provided with comprehensive information in order to allow informed decision-making.