Catalonia will advance mammograms to prevent breast cancer at age 45

Catalonia the age of the mammograms early detection of breast cancer at 45 years old and also the It will lengthen at 74. Currently, screening mammograms are performed every two years between 50 and 69. This expansion of the age spectrum for these screenings will be done stepwise throughout Catalonia from 2025. That is, it will not be done suddenly. So next year Women between 49 and 70 years old will be screened; in 2026, to those between 48 and 71 years old, and so on until 2029, the year in which in Catalonia they will be fully implemented screening mammograms for all women between 45 and 74 years old. The US recommends lowering mammograms at age 40 due to the increase in breast cancer in younger women. In Europe, all countries and even the European Commission recommend do not do them below 45 because at those ages they lose effectiveness.

“Right now we are evaluating the impact that this measure will have, since the volume of women who join these screenings implies a significant increase in activity,” explains Josep Alfons Espinàs, coordinator of the Cancer Screening Office of the Oncology Directorate of the Department of Health, to this newspaper. According to Espinàs , the department is aligned with the recommendations of the European Commission, who are committed to expanding mammograms to the age spectrum between 45 and 74 years.

“We agree that We will reduce mortality and gain life. But this decision involves making extra activity. Before the summer we will present our assessment to the Catalan Health Service (CatSalut). The resources must be put in place for next year, assume this extra part of expenses”, says Espinàs. The Ministry of Health is also considering incorporating the expansion of mammograms into the portfolio of services. If so, this would become mandatory throughout the health system. “But it’s something that should go linked to resources”, this expert warns.

In Catalonia, the directive of the Pla Director d’Oncologia is increase the age of these screenings little by little. “We would start gradually and in five years we would achieve full coverage. These things They are always progressive, They cannot be done at once. Next year we can start,” says Espinàs. According to the calculations of the Pla Director d’Oncologia, Each year added to these screenings will imply 10% more activity. That is, next 2025, screening people from 49 to 70 years of age will mean 10% more activity. In total, when the coverage sought is acquired, from 45 to 74 years of age, hospital activity will have increased by 50%, “a substantial change”, Therefore, it must be done in a phased manner, explains Espinàs.

The age group from 50 to 69, which is the one currently being screened, brings together the 47% of all breast cancers. The one from 70 to 74 years old, a 7%. And those between 45 and 49 years old, despite having a “lower risk”, represent the 10% of all breast cancers. “The populations that we incorporate represent the 17% of breast cancer in all of Catalonia”, precise.

Increase in young people

According to Espinàs, the idea of ​​lowering the age for breast cancer screening responds to the fact that there is a “certain tendency to increase” of this pathology in younger women. It occurs all over the world and is related, experts believe, to the obesity, alcohol consumption, late pregnancies or not having children, Inter alia. “This increase has been detected in the US. We have not done an exhaustive analysis in Catalonia and we do not have the impression that it happens as much here as there. Surely it happens a little, but not that much,” says Espinàs.

In the US, breast cancer rates in women aged 40 increase by 2% every year, according to a study recently presented in the ‘Journal of the American Medical Association’. “Here, the recommendations of the European Commission and the guidelines aim to reduce mammograms at age 45, but not at age 40. They even suggest that 40 to 45 should not have these control tests,” says Espinàs.

Personalized screenings

As required Sonia Pernas, coordinator of the Breast Cancer Unit of the Catalan Institute of Oncology (ICO), although mammography is, until now, the “best” screening test, “is not perfect.” On the other hand, it explains that screening women under 45 years of age is “debatable” because the breast is “very dense and here mammography has not proven to be as effective.” Furthermore, in women under 40 years old, Breast cancer is not that common. He also points out that in the US there are no public screening campaigns like in Catalonia and Spain, but everything is based on “recommendations”, as there are no There is universal healthcare there.

Pernas believes that expanding breast cancer screening to the 45-74 age group, despite the resources that have to be allocated to it, will mean a “investment worth evaluating.” Furthermore, the situation also opens the door to “more individualized screening.” That is, those who seek to determine the genetic causes. “We have to move towards personalized screening depending on the woman’s background and the risk factor’s, and not only depending on age,” claims this oncologist.