The United States preventive services task force has recommended women there begin biennial breast screening once they turn 40. The change from 50 years of age, recognises that more women under 50 are being diagnosed with breast cancer.
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00:00So, the rules in Australia are that breast screening, free, publicly funded breast screening
00:07is available for all women aged 40 and above.
00:12The target age range is 50-74.
00:16That means that women 50-74 are actively invited every two years, whereas those 40-49 are eligible
00:26but not invited.
00:28And why is that?
00:30I think that goes back to when screening was initiated.
00:35At that time, it was now 30 years ago, we had limited capacity and the technology was
00:42not as good as it currently is.
00:44And the decision was made to target the screening to those who would benefit most.
00:50And because breast cancer gets more common with age, and for some reasons that we can
00:55come to, mammographic screening is more effective in older women.
01:00The decision was made to specifically target women.
01:05Initially it was 50-69, it was extended some years ago to 50-74.
01:11But the 40-49 year olds, that situation hasn't changed.
01:17Eligible but not invited.
01:18Yeah, so Bruce, we know that screenings lead to a significant reduction in the risk of
01:23death from breast cancer.
01:24So why do we stop at 40?
01:26Why not screen 30-year-old women?
01:29So two reasons.
01:31One is the incidence of the disease, in that while women less than 50 do get breast cancer,
01:40some women less than 40 do get breast cancer.
01:43It is much less common.
01:46That's the first thing.
01:47So it does make sense to target those at highest risk.
01:52Secondly, younger women tend to have higher mammographic density.
01:56That's the appearance of the breast on a mammogram.
02:00High density means that the mammogram is less sensitive, meaning it's more, if there is
02:08a cancer there, it is less likely to find it in a woman with high density than low density.
02:16So what that means is the technology that we've got, that standard technology, is somewhat
02:23less effective in younger women.
02:25Put those two facts together and that's why the target range has been 50-74.