Keywords
Screening
Public health
Mammography
Categories
How to Cite
Abstract
Objective: to critically reflect on the current relevance of the breast cancer screening policy in Chile in relation to recent scientific and epidemiological evidence.
Design: reflective article grounded in a narrative review.
Method: an argumentative analysis was conducted based on national and international literature published within the past ten years, official epidemiological data, and international mammography screening guidelines.
Results: the national policy maintains the recommendation to initiate breast cancer screening at the age of 50, despite the increasing incidence among younger women and recent updates in international guidelines suggesting initiation at age 40. This approach restricts coverage and limits early detection among younger population groups.
Conclusions: the evidence supports revising Chile’s breast cancer screening policy with the aim of improving early detection, optimizing health outcomes, and promoting equity in access to preventive care.
References
1. International Agency for Research on Cancer. Global Cancer Observatory: Cancer Today. 2022. Disponible en: https://gco.iarc.fr/today
2. Duffy SW, Vulkan D, Cuckle H, Parmar D, Sheikh S, Smith RA, et al. Effect of mammographic screening from age 40 years on breast cancer mortality (UK Age trial): final results of a randomised controlled trial. Lancet Oncol. 2020;21(9):1165–1172. Disponible en: http://dx.doi.org/10.1016/S1470-2045(20)30398-3
3. Moran P, Cullinan J. Is mammography screening an effective public health intervention? Evidence from a natural experiment. Soc Sci Med. 2022;305:115073. Disponible en: https://doi.org/10.1016/j.socscimed.2022.115073
4. Aguayo Ormeño I. Patología GES: cáncer de mama y mamografías en Chile. Biblioteca del Congreso Nacional de Chile. 2023. Disponible en: https://obtienearchivo.bcn.cl/obtienearchivo?id=repositorio/10221/34431/1/202307_BCN_Cancer_de_mama_y_mamografias.pdf
5. Ministerio de Salud. Plan Nacional de Cáncer 2018–2028. 2018. Disponible en: https://cdn.digital.gob.cl/filer_public/d3/0a/d30a1f5e-53d9-4a31-a4fe-e90d8d9a2348/documento_plan_nacional_de_cancer.pdf
6. Departamento de Estadísticas e Información de Salud. Defunciones y mortalidad por tumor maligno de la mama (CIE-10: C50). 2022. Disponible en: https://deis.minsal.cl/
7. Johnson RH, Anders CK, Litton JK, Ruddy KJ, Bleyer A. Breast cancer in adolescents and young adults. Pediatr Blood Cancer. 2018;65(12):e27397. Disponible en: http://dx.doi.org/10.1002/pbc.27397
8. Oshi M, Yamada A, Gandhi S, Wu R, Sasamoto M, Yamamoto S, et al. Breast cancer in adolescents and young adults has a specific biology and poor patient outcome compared with older patients. ESMO Open. 2024;9(11):103737. Disponible en: http://dx.doi.org/10.1016/j.esmoop.2024.103737
9. Hassaine Y, Jacquet E, Seigneurin A, Delafosse P. Evolution of breast cancer incidence in young women in a French registry from 1990 to 2018: towards a change in screening strategy? Breast Cancer Res. 2022;24(1):87. Disponible en: https://doi.org/10.1186/s13058-022-01581-5
10. Tandon M, Varghese T, Jafferbhoy S, Marla S, Narayanan S, Soumian S. Breast cancer under age 40 over last decade: a retrospective analysis. Eur J Surg Oncol. 2023;49(5):e269. Disponible en: https://doi.org/10.1016/j.ejso.2023.03.200
11. Xu S, Murtagh S, Han Y, Wan F, Toriola AT. Breast cancer incidence among US women aged 20 to 49 years by race, stage, and hormone receptor status. JAMA Netw Open. 2024;7(1):e2353331. Disponible en: https://doi.org/10.1001/jamanetworkopen.2023.53331
12. Ministerio de Salud. Guía de Práctica Clínica AUGE: cáncer de mama. 2015. Disponible en: https://diprece.minsal.cl/wrdprss_minsal/wp-content/uploads/2016/05/GPC-MAMA.pdf
13. US Preventive Services Task Force, Nicholson WK, Silverstein M, Wong JB, Barry MJ, Chelmow D, Coker TR, Davis EM, Jaén CR, Krousel-Wood M, Lee S, Li L, Mangione CM, Rao G, Ruiz JM, Stevermer JJ, Tsevat J, Underwood SM, Wiehe S. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. 2024;331(22):1918–1930. Disponible en: http://dx.doi.org/10.1001/jama.2024.5534
14. Biblioteca del Congreso Nacional de Chile. Ley N° 21.551 que exime del requisito de orden médica para examen preventivo de mamografía y establece obligaciones a los prestadores de salud. 2023. Disponible en: https://www.bcn.cl/leychile/navegar?idNorma=1191379
15. Superintendencia de Salud. Circular IF/N°435 que instruye sobre la exención del requisito de orden médica para la mamografía en el Examen de Medicina Preventiva. 2023. Disponible en: https://www.superdesalud.gob.cl/normativa/circular-if-n435/
16. Trentham-Dietz A, Chapman CH, Jayasekera J, Lowry KP, Heckman-Stoddard BM, Hampton JM, Caswell-Jin JL, Gangnon RE, Lu Y, Huang H, Stein S, Sun L, Gil Quessep EJ, Yang Y, Lu Y, Song J, Muñoz DF, Li Y, Kurian AW, Kerlikowske K, et al. Collaborative modeling to compare different breast cancer screening strategies: a decision analysis for the US Preventive Services Task Force. JAMA. 2024;331(22):1947–1960. Disponible en: http://dx.doi.org/10.1001/jama.2023.24766
17. American College of Obstetricians and Gynecologists. Age to initiate routine breast cancer screening: ACOG clinical practice update. Obstet Gynecol. 2025;145(1):e40–e44. Disponible en: http://dx.doi.org/10.1097/AOG.0000000000005757
18. Wilkinson AN, Mainprize JG, Yaffe MJ, Robinson J, Cordeiro E, Look Hong NJ, Williams P, Moideen N, Renaud J, Seely JM, Rushton M. Cost-effectiveness of breast cancer screening using digital mammography in Canada. JAMA Netw Open. 2025;8(1):e2452821. Disponible en: http://dx.doi.org/10.1001/jamanetworkopen.2024.52821
19. Marcon M, Fuchsjäger MH, Clauser P, Mann RM. ESR essentials: screening for breast cancer – general recommendations by EUSOBI. Eur Radiol. 2024;34(10):6348–6357. Disponible en: http://dx.doi.org/10.1007/s00330-024-10740-5
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright (c) 2026 Contemporary Midwifery Journal