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Netherlands mammography analysis prompts questioning of age-based screening for breast cancer and demonstrates more harm than good in the over 70s

A retrospective study of the effect of extending mammography to age 75 was performed in the Netherlands to use data emerging from the change of policy shifting age-based mammography to 75 in 1999. More early stage tumours were detected but just as many cases of late-stage disease were discovered as before, implying that screening had not eliminated them and was not yielding a benefit. Further analysis confirmed that the harmful effects of over-treatment in this age group were outweighing any potential benefits of cancer detection. Dr. Liefers concluded that age-based screening is failing these patients who should receive mammography on a personalised risk and performance-status profile rather than on age. He commented that similar observations were also valid when considering screening women under 50 and that it is justified to raise questions about the validity of all age-based screening for breast cancer which could be replaced by individualised screening based on risk profiles especially as these increasingly include genomic as well as classical risk factors.

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