Race and Ethnicity-Adjusted Age Recommendation for Initiating Breast Cancer Screening

Area of Science:

• Oncology
• Public Health
• Health Disparities

Background:

• Breast cancer (BC) is a leading cause of cancer death in women, with significant racial disparities in mortality, particularly for early-onset BC in Black women.
• Current BC screening guidelines, often recommending a universal starting age of 50, may not be equitable or optimal given these disparities.

Purpose of the Study:

• To determine race and ethnicity-adapted starting ages for breast cancer screening.
• To address current racial and ethnic disparities in BC mortality using population-based data.

Main Methods:

• A nationwide, population-based, cross-sectional study analyzed US female breast cancer mortality data from 2011-2020.
• Risk-adapted starting ages were calculated based on the 10-year cumulative risk of BC-specific death for different racial and ethnic groups.

Main Results:

• Black females reached the 0.329% 10-year cumulative BC death risk threshold at age 42, 8 years earlier than White females (age 51).
• American Indian/Alaska Native and Hispanic females reached this threshold at age 57, while Asian/Pacific Islander females reached it at age 61.
• Race-adapted screening could mean starting mass screening 6-7 years earlier for Black females.

Conclusions:

• This study provides evidence for race-adapted starting ages for breast cancer screening.
• A risk-adapted approach, considering individual race and ethnicity, may improve screening equity and reduce mortality from early-onset BC.