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Mammography Rates Fall for Women in 40s | Mammo AI Trials
February 6, 2025
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“[I]t seems probable that standard doublereading of mammograms will be phased out from organised breast screening programmes if additional trials or implementation studies show broadly similar screen-detection findings to those from the MASAI trial.”
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Houssami, N and Marinovich ML, commenting on newly published results from the MASAI trial.
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A new study on mammography screening confirms the worst fears of women’s health advocates: screening rates fell for women ages 40-49 after the USPSTF in 2009 withdrew its recommendation that younger women get biennial screening.
Breast screening has long been the most controversial cancer screening exam, with screening’s opponents claiming that its “harms” – such as breast biopsies and overdiagnosis – don’t justify its benefits.
- The anti-mammography wave crested in 2009 when the USPSTF withdrew its screening recommendation for women ages 40-49 and older than 75, instead advising them to consult with their physicians.
The change prompted confusion and anger that persisted until the task force in 2024 rescinded the 2009 guidance and returned to a broad recommendation in favor of biennial screening for women in their 40s (screening still isn’t recommended for women over 74).
- This left the breast imaging community pondering the impact that 15 years of the more restrictive guidance had on breast screening rates.
Researchers address that question in a new study in JAMA Network Open, in which they analyzed screening records for 1.6M women, finding the probability of getting a biennial mammogram …
- Fell -1.1 percentage points for all women ages 40-49.
- Fell -3 percentage points for non-Hispanic Black women 40-49, the biggest decline among younger women.
- Fell -4.8 percentage points for all women 75 years and older.
- Fell -6.2 percentage points for Hispanic women over age 75, the biggest decline among all age groups.
The new research confirms other studies finding that the USPSTF 2009 guidance led to a small – but statistically significant – decline in overall breast screening rates.
- What’s new is its discovery of demographic variations in the magnitude of the change, an important finding given recent studies showing that Black women have a 39% higher breast cancer mortality rate.
In fact, rising cancer risk in Black women was cited by the USPSTF as one of its reasons for changing its guidance in 2024.
- The USPSTF estimated that lowering screening’s starting age to 40 would avert 1.8 additional deaths per 1k Black women screened every two years
The Takeaway
Hopefully, we’ve seen the end of the “mammography wars” that led to the USPSTF’s 2009 guideline change. A better future is one in which breast screening decisions are made with consideration for factors like cancer risk in addition to just age.
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Leading the Way in AI Transparency
There’s a need to better inform radiologists about AI’s role when interpreting images and generating measurements. Visage Imaging’s Visage 7 can display text in the viewer indicating that AI was used as a diagnostic aid – find out how it works today.
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Missed Appointments and Cancellations Can Add Up
Every missed appointment can cost providers an average of $200. PocketHealth Appointment Reminders can decrease no-show rates by up to 30%. Find out how in this article.
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The Invisible Edge of Data Migration
AI-enabled data migration has several advantages for healthcare organizations, from efficiency that’s 5-10X faster than traditional methods to success rates as high as 99%. Learn more on this page from Enlitic.
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- MASAI Results Published: Results from the landmark MASAI trial of AI for screening mammography were published this week in The Lancet Digital Health. The findings mostly track with data presented at ECR 2024, but are still worth noting: The use of ScreenPoint Medical’s Transpara algorithm instead of a second radiologist in double reading exams of 106k Swedish women boosted the cancer detection rate (6.4 vs. 5 cancers per 1k women), while reducing workload 44%. An editorial said MASAI’s findings could spell the end of double-reading mammography.
- UK to Launch Massive Breast AI Trial: Meanwhile, the U.K. plans to launch a massive clinical trial of mammography AI that will include 700k women. Called the EDITH trial, the study will examine whether AI can be used instead of a second radiologist for double-reading screening mammograms (a similar protocol to that used in the MASAI trial). The U.K.’s National Institute for Health and Care Research is backing EDITH with £11 million ($14M) in funding, which will be used to recruit 30 sites around the country.
- Mammo AI Directs Breast MRI: In another important paper this week on ScreenPoint Medical’s Transpara algorithm, Dutch researchers used the solution to select intermediate-risk women for supplemental breast MRI screening. In a paper in Radiology, Transpara analyzed screening mammograms for 760 women who met a 50% risk threshold and got breast MRI. There were 37 cancers, 49% visible on mammography, with AI selecting 84% of them for supplemental screening, showing that AI can help clinicians make better use of breast MRI in areas with limited access.
- KLAS Winners Announced: Market analysis firm KLAS Research announced the 2025 winners of their Best in KLAS awards, with several radiology IT vendors among the winners. Award recipients included Merge by Merative (cardiology and cardiology hemodynamics), Microsoft/Nuance (image exchange), Sectra (large and small PACS), AGFA HealthCare (universal viewer and enterprise imaging VNA), Intelerad (PACS in the U.K. and Ireland), and Solventum (front-end speech recognition).
- Patients Not Getting Nodule Follow-Up: More than 50% of patients with CT-detected incidental solitary pulmonary nodules didn’t get appropriate follow-up in a new study in American Journal of Medicine Open. Researchers from New York reviewed records for 341 patients with SPNs, finding that 52% met Fleischner Society guidelines for follow-up but didn’t get a recommendation for it from the interpreting radiologist. Only patients with emphysema had a higher odds ratio for getting follow-up (OR=1.91).
- Riverain Touts Vessel Suppression: Riverain Technologies is highlighting results of an RSNA 2024 study in which its ClearRead CT Vessel Suppression solution helped radiologists better visualize pulmonary nodules. In a study with 4.4k patients, researchers noted a drop in the average time from study opening to preliminary signing (19 vs. 12 minutes) and an increase in reporting of smaller punctate nodules (24% vs. 13%). Riverain also touted 147% revenue growth in 2024 and its launch in 2025 of an FDA-cleared solution for coronary artery calcification scoring.
- Advanced Prostate Cancer Rises: Rates of advanced prostate cancer have risen since 2012, when the USPSTF withdrew its recommendation that men be routinely screened with PSA tests. In a study in JAMA Network Open, UC San Francisco researchers studied 388k prostate cancer cases in California from 2004 to 2021, finding that mortality fell 2.6% a year from 2004-2012 but the decline stopped from 2012-2021. Rates of distant disease fell 2004-2011 but then rose 6.7% annually 2011-2021. MRI is recommended to work up men with suspicious PSA tests.
- CCTA Detects COVID’s Heart Impact: As if COVID-19 itself weren’t bad enough, the SARS-CoV-2 virus can also exacerbate coronary plaque buildup. In a new paper in Radiology, researchers from China used coronary CT angiography to follow 803 patients from 2018 to 2023, finding those with SARS-CoV-2 infection and coronary artery lesions had faster growth in percent atheroma volume (0.90% vs. 0.62% per year), as well as higher likelihood of high-risk plaque (21% vs. 16%) and target lesion failure (10% vs. 3.1%).
- AI Reduces CCTA Radiation Dose: Another study from China is validating the use of AI-based reconstruction to reduce radiation dose for coronary CT angiography. In a paper in European Journal of Radiology, researchers used Canon Medical’s Precise IQ Engine super-resolution deep learning reconstruction on CCTA images acquired at ultra-low doses in 50 patients. PIQE-reconstructed CCTA images had 60% lower radiation dose compared to those using low-dose hybrid iterative reconstruction (0.8 vs. 2.01 mSv), with equivalent or superior image quality and less image noise.
- RapidAI’s Lumina 3D Is Cleared: The FDA cleared RapidAI’s Lumina 3D solution for automatically creating 3D reconstructions of head and neck CT angiography scans. Lumina 3D replaces manual workflows to provide 3D views of head and neck vasculature, including vessel segmentation and bone removal. The solution is designed for large-scale application at healthcare networks using RapidAI’s Rapid Enterprise Platform, which the company released at RSNA 2024.
- RP Group Renews with UnitedHealthcare: A Texas radiology group affiliated with Radiology Partners has returned to the UnitedHealthcare network following a two-year lapse. ARA Diagnostic Imaging said it reached a long-term agreement with UnitedHealthcare that restores in-network status to ARA providers. The contract between the parties expired in 2023 when UnitedHealthcare rejected what it said was a 34% price hike by ARA. RP and UnitedHealthcare last year settled a separate dispute in Texas over billing by an RP-affiliated practice in Houston.
- NY Times Article Scans AI Use: An opinion article this week in the New York Times generated buzz over the best use of AI to support doctors. Eric Topol, MD, and Pranav Rajpurkar, PhD, noted recent research studies in which AI outperformed physicians for interpreting images – but radiologists still favored their own judgment over AI. That led them to suggest three models for AI deployment, the most “radical” of which was having AI independently handle routine tasks like chest X-rays or normal mammograms while physicians focused on complex cases.
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Tools for Lung Cancer Screening in Europe
As lung cancer screening programs gear up to launch across various European countries, the integration of AI nodule detection tools promises to enhance the accuracy of low-dose CT scans. Watch this video from Riverain Technologies to learn more.
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Experience the Power of Workflow Orchestration
Mach7’s UnityVue Workflow Orchestration Platform is a groundbreaking new solution that creates a unified view of patient imaging data, speeding patient care delivery, creating more efficient workflows, and reducing radiologist stress. Experience the power of UnityVue for yourself.
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AI and Neuroradiology Workflow
How can AI add value to workflows in neuroradiology? Watch this on-demand video to learn from Blackford partners how AI can help, from assisting providers in managing acute stroke patients to the impact of CPT III codes in driving adoption of brain volumetric AI solutions.
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- Feel the Freedom of Helium-Free MRI: Lift limitations and experience MRI excellence with Philips BlueSeal, the industry’s lightest, vent pipe-free, high-performance, helium-free 1.5T scanner. Save on helium and energy costs, achieve precise AI-enhanced diagnoses, enjoy faster scans, and optimized workflows. Learn more today.
- 3 Ways AI Can Enhance Radiology Workflows: While disease detection was the initial driver for AI in radiology, the technology can also help improve workflows and reduce workloads for radiologists. Learn how AI can contribute in this article from Merge by Merative.
- 3 Good Reasons to Add Mammography: There are three good reasons to add mammography services at your imaging site as providers expect higher demand for breast imaging services. Get the facts about mammography on this resource page from Siemens Healthineers.
- Visit AGFA at HIMSS 2025: AGFA HealthCare will be showcasing its latest innovations in cloud-based enterprise imaging at the upcoming HIMSS 2025 conference in Las Vegas. Schedule a visit to AGFA’s booth #5027 to see how the company is reshaping and simplifying medical image management.
- AI-Empowered CT Workflow: CT systems from United Imaging are designed for high image quality and low dose, and their AI-empowered workflow enables fast and reproducible positioning, helping you image patients with confidence. Learn more on this page.
- Empower Your Healthcare Workforce at HIMSS 2025: Visit Microsoft at HIMSS 2025 to learn how to empower your healthcare workforce, unlock value from clinical and operational data, and accelerate discovery and development. Schedule a demo today or visit booth #2221.
- Secure and Scalable Radiology AI Adoption: CARPL’s Unboxing AI webinar series takes a deep dive into radiology AI adoption with a four-part series hosted by CEO Vidur Mahajan, MD. Learn how a platform approach can help you realize the full potential of an integrated AI ecosystem.
- Imaging Workflows that Actually Work: Not a fan of medical image exchange on discs? Then check out Clearpath and find out how it’s removing obstacles to better radiology workflow. Request a demo today.
- Say Goodbye to On-Premises Costs: Free up resources with Optum’s cloud solutions for medical imaging that will help you say goodbye to on-premises costs. Visit this page to see how they can help you save!
- Harnessing the Power of AI to Improve Patient Care: Endeavor Health is one of the first healthcare providers in the Midwest to use AI in the echocardiography lab. Learn how they are harnessing echo AI’s tremendous potential to improve diagnostic capabilities and help patients on this page from Us2.ai.
- AI for Pediatric Fracture Detection: Pediatric fractures are common but can be easily missed on radiography. Meanwhile, AI tools for fracture detection have mostly been tested in adults. Learn how Gleamer’s BoneView AI solution helped clinicians find fractures in kids in a recent research study.
- Unprecedented Insights Made Possible with AI: With the largest normative dataset of whole-body imaging in the world, Prenuvo’s AI researchers partner with the best academic minds to understand – like never before – what “normal” aging means. Learn about their work today.
- AI for Lung Cancer Diagnosis and Screening: Check out this comprehensive new eBook from Calantic by Bayer on the role of AI in lung cancer diagnosis and screening. It explores AI’s potential role in improving lung cancer screening strategies, identifying high-risk individuals, and enhancing diagnostic accuracy. Download it today.
- Get the 2024 Radiology Practice Development Report: Medality surveyed more than 3,300 radiologists and discovered the most critical training gaps and growth opportunities in radiology for its 2024 Radiology Practice Development Report. Download your complimentary report today.
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- Answers in Sight at HIMSS 2025: Join Intelerad at HIMSS 2025 to explore how they are redefining healthcare imaging with innovative solutions designed to provide a clear path to answers. Book a meeting today or drop by at booth #1048.
- The Future of SmartTechnology: SmartTechnology is DeepHealth’s solution for bringing informatics and imaging systems closer together by embedding informatics into hardware, creating completely new workflows. Learn how it works in this interview with CTO Sham Sokka.
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