The current guidelines can be expected to evolve with the accrual of new knowledge and new technological advances. For example, the technical quality of mammograms and their interpretation are critical factors in their usefulness. Mammographic detection of cancer is more problematic in the dense breast tissue of younger women, whose tumor growth rates are generally more rapid. After analyzing the same body of evidence from randomized mammography studies, expert committees have reached different conclusions regarding routine mammographic screening of asymptomatic women 40 to 49 years of age. The American Cancer Society, National Cancer Institute, and other groups have recommended annual mammography for women beginning at 40 years of age, but the NCI Consensus Panel did not.
Clinicians can help prevent and detect cancer at early stages.
They can prevent environmental cancers by counseling patients to avoid tobacco use, asbestos exposure, and unnecessary exposure to ionizing radiation. A brief medical and family history can reveal an unusual predisposition to cancer and a need for closer medical surveillance. In the course of the physical examination, attention to signs of early cancer can lead to curative treatment.