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Mammograms should start at age 40, hormone therapy for menopause is safe, studies find


It's been a big week in women's health news. There is a new recommendation from the U.S. Preventive Services Task Force on what age to start mammograms and an important new study on the use of hormone therapy to tackle the annoying symptoms of menopause. NPR's Allison Aubrey is here to help us understand these developments. Hey, Allison.

ALLISON AUBREY, BYLINE: Good morning, Ayesha.

RASCOE: So let's start with breast cancer screening. What's new?

AUBREY: Well, there've been conflicting recommendations on what age to start getting mammograms to screen for breast cancer. The task force now says all women should start by age 40. The previous recommendation was to start no later than 50. A big factor in this change, Ayesha, is the rise in breast cancer among women in their 40s. I spoke to doctor Wanda Nicholson. She's the chair of the U.S. Preventive Services Task Force. She says the evidence is clear that early detection saves lives.

WANDA NICHOLSON: By starting at age 40 continuing every other year, we found that we can reduce cancer deaths substantially, up to nearly 20% more lives saved.

AUBREY: That's about 8,000 lives a year they estimate if every woman followed the recommendation to get a mammogram every other year.

RASCOE: Eight-thousand is a lot, and, you know, every life saved is significant to that person and their families. So this seems like a big deal.

AUBREY: Absolutely. And Dr. Nicholson says just that, all women can benefit from the screening. She also told me she wants to especially encourage Black women to follow the recommendations.

NICHOLSON: Black women are 40% more likely to die from breast cancer compared to white women. We also know that all too often that Black women get more aggressive cancers at an earlier age.

AUBREY: The reasons for this, Ayesha, are not completely understood, and the task force is actually calling for more research to better understand it.

RASCOE: So given all that, why is the new recommendation to get a mammogram every other year? Why not get screened annually?

AUBREY: Well, the task force is not opposed to women opting for more frequent screenings. Their recommendation is based on the evidence they've reviewed so far, which suggests every other year is effective. But many, many doctors and health care systems do recommend annual screenings. And people at higher risk due to genetics, family history, or people with dense breasts may be referred for additional screenings, including a 3D mammogram, ultrasound or an MRI.

RASCOE: Let's move on to hormone therapy for menopause. This topic has been getting a lot of attention, even on Capitol Hill. What do women need to know?

AUBREY: Yeah, if you missed it, the actor Halle Berry visited the Capitol on Thursday, pushing for more research and education on menopause. While there, she kind of screamed out, I'm in menopause, OK? - during a press conference, as in, you know, look. It's nothing to be ashamed of. Let's talk about it. What women need to know about menopause hormone therapy is that it's safe when started before the age of 60.

And to explain this, let me back up a little. A lot of women stopped taking hormone therapy about 22 years ago when a very large study called the Women's Health Initiative found that women taking Prempro, a type of hormone therapy, increased the risk of breast cancer and strokes. Now, when researchers documented this, the trial was halted, and prescriptions plummeted.

RASCOE: So what has changed since then?

AUBREY: Well, over the last 20 years, safer alternatives have been introduced using different types of hormones and lower doses. And the new review published in the medical journal JAMA finds women under the age of 60 can benefit from hormone therapy. I spoke to the study author, Dr. JoAnn Manson. She's chief of preventive medicine at Brigham and Women's Hospital.

JOANN MANSON: Menopausal hormone therapy has low risk of adverse events and would be safe for treating bothersome hot flashes, night sweats and other menopausal symptoms.

AUBREY: Now, menopause experts say there's no one size fits all. There's lots of options available. And women who want to try should typically start the therapy between the ages of 50 and 60.

RASCOE: That's NPR's health correspondent Allison Aubrey. Thank you so much.

AUBREY: Thank you. Great to be here.

(SOUNDBITE OF SADE'S "SIEMPRE HAY ESPERANZA") Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Allison Aubrey is a correspondent for NPR News, where her stories can be heard on Morning Edition and All Things Considered. She's also a contributor to the PBS NewsHour and is one of the hosts of NPR's Life Kit.