Mammography deemed cost-effective for healthy older women

Biennial breast cancer screening after age 65 is probably cost effective for women without significant comorbidities, according to the Cost Work Group of the US Preventive Services Task Force.

Almost half of all new cases of breast cancer, and nearly two thirds of deaths, occur in women 65 years of age or older, Dr. Jeanne Mandelblatt and colleagues note in the Annals of Internal Medicine for November 18. It remains unclear whether mammography is cost effective for older women.Dr. Mandelblatt, with Georgetown University Medical Center in Washington, DC, and colleagues reviewed cost-effectiveness studies published between 1989 and 2002 that analyzed breast cancer screening after age 65.The ten studies they identified were “fairly consistent,” the Task Force observes, with incremental costs of $34,000 to $88,000 per life-year saved, compared with discontinuing mammography at age 65.However, relative costs increase and harm may outweigh benefits in women with comorbidities that limit their life expectancy to no more than 5 years, the authors point out. Breast cancer may be more benign in older women than in their younger counterparts, they note, and patients’ preferences about quality of life may change over time. Therefore, further research into such issues is required before optimal approaches for breast cancer screening can be delineated.(Source: Ann Intern Med 2003;139:835-842: Reuters Health: November 17, 2003: Oncolink)