American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Breast cancer screening guideline change may adversely affect non-whites

OCTOBER 24, 2017
Clinical Congress Daily Highlights, Tuesday First Edition

A recent increase in the recommended universal screening age for breast cancer by the U.S. Preventive Services Task Force (USPSTF) may not apply as well to minority populations as it does to those of European ancestry. Analysis of the Surveillance, Epidemiology, and End Results (SEER) database for 728,315 breast cancer patients from 1973 to 2010 found a significantly higher proportion of diagnoses under age 50 in non-whites (27.6 percent in blacks, 31.3 percent in Hispanics, 29.2 percent in Asians) than in whites (20.7 percent). 

The review, which compared both age of diagnosis and extent of disease on presentation across racial groups, was done by a Massachusetts General Hospital/Harvard Medical School group led by David C. Chang, PhD.

The SEER data contained 77 percent whites, 9.2 percent blacks, 7 percent Hispanics and 6.2 percent Asians, with an overall median age of 59. In addition to the differences in age at diagnosis, the review found that blacks and Hispanics are more likely to present with regional or distant disease (46.6 percent and 42.9 percent, respectively) than whites and Asians (37.1 percent and 35.6 percent, respectively).

The authors concluded that raising the universal screening age for breast cancer to 50 may adversely affect non-white populations and caution should be exercised in non-U.S. and non-European countries when adopting practice guidelines based on American and European data.

Additional Information:
This Scientific Forum study was presented October 24 at the 2017 Clinical Congress of the American College of Surgeons in San Diego, CA.  Program, webcast and audio information is available online at FACS.org/clincon2017. View the full abstract here.

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