You don’t Need An Annual Mammogram or An Annual Pap Test—Here’s Why

[Addendum 7-10-2016: In references (3) and (4) below I have placed the 2016 US Preventive Services Task Force updated breast cancer screening recommendations.]

“For years, women were advised to start mammography screening at 40; then, in 2009, the United States Preventive Services Task Force raised the recommended age to 50 – and specified every two years, rather than annually.

Last week, the task force and medical groups, including the American Cancer Society, recommended cervical cancer screening with the Pap smear no more than every three years, and said women should not begin screening until age 21. In the past, screening was recommended every one to two years, within a few years of becoming sexually active.” (1)

The reason for these new recommendations is not to save money. It is to prevent suffering. There is no evidence that the old recommendations for frequent screening were necessary to save lives. What they did do was lead to a large number of unnecessary worry and unnecessary tests.

The original randomized trial of mammography was begun in 1963 and after ten years of follow-up women over fifty were found to be 30% less likely to die of breast cancer if they were in the mammography screening group as compared to those in the non-mammograpy screening group but there was noreduction in breast cancer deaths in women in their forties. Despite the lack of evidence, the American Cancer Society recommended that mammography begin at forty. By 1992  nine more randomized controlled mammography trials had been finished and none of these studies showed  that mammography reduced the death rate in younger women (less than 50 years of age). (2)

Finally, in 2009 The US Preventive Health Services Task Force recommended  beginning screening mammography at 50 years of age. (3)

(1) The Annual Appointment Loses Some Relevance available at

(2) Overdiagnosed: Making People Sick in the Pursuit of Health. H. Gilbert Welch, 2011. Beacon Press. pp. 74-77.

(3) Breast Cancer: Screening Release (Summary) Date: January 2016. The US Prentive Services Task Force

(4) Final Recommendation Statement: Breast Cancer Screening (Full Text) 2016. The US Preventive Services Task Force

This entry was posted in Internal Medicine, Obstetrics and Gynecology, Preventive Medicine. Bookmark the permalink.