By Dulce Maria Ruelas
Faculty, College of Nursing and Health Care Professions
October was Breast Cancer Awareness Month. However, as a public health practitioner, awareness is ongoing. Breast cancer is the most commonly diagnosed cancer in all race and ethnic background women (Lee et al., 2017). Most recent data (2014) positions breast cancer at an incidence of 236,968 new cases a year, which is a rate of 123.9 percent and 41, 211 deaths. This translates to a 20.5 percent yearly death rate among women (CDC, 2017). Current data (2014) records that the highest rate of incidence was in women ages 70-74 (CDC, 2017). In 2009 United States Preventive Services Task Force (USPSTF) recommended there be biennial screening for women ages 50-74. The screening recommendation age has now shifted ten years. This means that screening now starts at age 40 and the timing from yearly to biennial, (Qin, Tangka, Guy, & Howard, 2016) thus then decreasing potential mammography’s among average-risk women of all ethnicities.
In 2009 the USPSTF provided their recommendation based on studies that provided epidemiological data to save one life and reduce mortality for the determination of proper population health decisions (Bhattacharya, 2013), shifting how screenings occur in the United States. This change translated into average-risk women in the younger age range to join other at-risk women to discuss their possibilities (potential benefit or harm) with their healthcare provider, an assumption that everyone has access to care.
The effectiveness of screening for the reduction of mortality rates is the ultimate goal of the USPSTF recommendation. A recommendation that assisted the healthcare industry to implement across clinics, hospitals, facilities and public health using scientific evidence that determined potential harm or benefits for population health (the most women) based on its interpretation at the time (Bhattacharya, 2013). Mandelblatt et al. (2016) reveal that there has since (2009) been new benefits of screening that average-risk women can take advantage of to reduce breast cancer. There are new screenings that include digital mammography and standardization of treatment regimes in comparison to only film mammography. So what do all these new policies or recommendations mean to you? It means talk to your health care provider, address the issue of self-examination, mammography screenings and do not fear to bring this concept up when you have a well women exam regardless of your age. The more you become aware and used to discussing prevention the better you can prepare.
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- Bhattacharya, D. (2013). Public health policy: Issues, theories, and advocacy. San Francisco, CA: Jossey-Bass.
- Centers for Disease Control and Prevention. (2017). United States cancer statistics: Data visualizations. Retrieved from https://gis.cdc.gov/grasp/USCS/DataViz.html
- Lee, H., Sharratt, M., Ghebre, R., Le, C., Jang, Y. J., & Yee, D. (2017). Mobile phone multilevel and multimedia messaging intervention for breast cancer screening: Pilot randomized controlled Trial. Journal of Medical Internet Research, Mhealth and Uhealth, 5(11), e154. doi:10.2196/mhealth.7091
- Mandelblatt, J. S., Stout, N. K., Schechter, C. B., van den Broek, J. J., Miglioretti, D. L., Krapcho, M., & … Xuelin, H. (2016). Collaborative modeling of the benefits and harms associated with different U.S. breast cancer screening strategies. Annals of Internal Medicine, 164(4), 215. doi:10.7326/M15-1536
- Qin, X., Tangka, F. L., Guy, G. J., & Howard, D. H. (2016). Mammography rates after the 2009 revision to the United States Preventive Services Task Force breast cancer screening recommendation. Cancer Causes & Control, 28(1), 41-48.