Impact of age-specific recommendation changes on organized breast screening programs.

Background: Recent changes in recommendations for mammography screening for women in their forties could have an impact on organized screening programs, as these require clear definition of target and eligible populations.
Current Status: Internationally, a majority of programs target women fifty and over, and so the recent USPSTF age recommendations for screening are quite consistent with this practice. However, there is a good deal of variability in the availability of population-based screening programs to women in their forties should they choose to participate.
Future Impact: Several programs are reviewing recommendations regarding the eligibility of women in their forties; as guidelines indicate women in this age group should be eligible for screening, even if not targeted, there is discussion as to whether they should be allowed in programs so that they benefit from the same programmatic quality assurance afforded to the target population of women over 50. Clear communication of the evidentiary basis for the eligibility criteria and target populations is required, so that the public is aware that programs are designed to deliver maximal population impact, while minimizing population risk.
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