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March 1, 1995

Mammographic Screening in Women Younger Than 50 Years-Reply

Author Affiliations

Department of Health and Human Services Washington, DC
UCLA Breast Center Los Angeles, Calif

JAMA. 1995;273(9):702. doi:10.1001/jama.1995.03520330031029

In Reply.  —Unlike Dr Kopans, we believe that public policies about screening should be based on verifiable, published information. The unpublished meta-analysis to which Kopans refers excludes the major Canadian study,1 which was the only study explicitly designed to assess the value of screening women younger than 50 years, and includes unpublished data from the Gothenburg study. Thus, significance is only achieved by the selective inclusion of data.Kopans' unreferenced allegation that radiation after 40 years of age carries no increased risk of cancer is wrong, as two recent studies show.2,3 While contemporary radiation-induced cancer risks from mammography are much lower than those in past studies, the younger a woman is when regular radiation exposure begins, the greater her lifetime risk.4Moreover, providing mammographic screening to women in their 20s and 30s, as some are doing today, could place them at increased radiogenic risk, both from the

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