May is Women’s Health Month and an opportunity to highlight the importance of disease prevention in women. Imaging plays a critical role in early detection of common high‑impact conditions including breast cancer, osteoporosis, atherosclerotic cardiovascular disease (ACVD), and lung cancer.

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Breast Cancer Screening

Breast cancer has an almost 13% lifetime risk among women. It remains the most common non‑skin cancer and the second leading cause of cancer death in women. Routine mammography has strong evidence supporting its ability to reduce mortality.

The American College of Radiology recommends:

• Annual screening mammograms for average‑risk women starting at age 40
• Continuing yearly through age 80
• Using 3D tomosynthesis for improved cancer detection and fewer callbacks

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Osteoporosis Screening

Osteoporosis affects about one in five women over age 50 in the U.S., and 80% of Americans diagnosed with osteoporosis are women. Consequences of osteoporotic fractures can include psychological distress, loss of mobility, reduced ability to perform daily activities, and increased mortality.

DEXA scanning is a low‑dose X‑ray exam that measures bone mineral density.

Guidelines recommend:

• Screening all women age 65 and older
• Screening women ages 50–64 with risk factors such as menopause, low body weight, parental hip fracture, smoking, or excess alcohol intake

Recommended DEXA frequency:

• High‑risk: every 2 years
• Moderate‑risk: every 3–5 years
• Low‑risk: every 5–10 years

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Atherosclerotic Cardiovascular Disease (ACVD) Screening

ACVD is the leading cause of death among U.S. women, affecting more than 60 million.

Standard screening evaluates:

• Blood pressure
• Cholesterol
• Diabetes
• Obesity
• Menopausal status

Coronary artery calcium (CAC) scoring provides a highly specific measure of coronary atherosclerosis. When added to traditional assessments, it improves cardiovascular risk prediction and supports more informed treatment decisions.

CAC‑CT details:

• Non‑contrast CT with ECG gating
• Uses Agatston scoring
• Radiation dose comparable to a mammogram or lung screening CT

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Lung Cancer Screening

Lung cancer is the second most common non‑skin cancer in women and the leading cause of cancer death. Nearly 20% of women in the U.S. are current smokers.

Lifetime lung cancer risk:

• Current smokers: 11.2%
• Former smokers: 5.8%
• Never‑smokers: 1.3%

Low‑Dose CT (LDCT) screening is recommended for:

• Adults ages 50–80
• Current or former smokers with a 20+ pack‑year history

Updated 2023 guidelines no longer consider how many years have passed since quitting smoking. LDCT uses significantly less radiation than a standard chest CT.

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These widely available imaging exams play a crucial role in helping women stay proactive about their health through early detection and prevention.

Sources

1. Philpotts LE, Grewal JK, Horvath LJ, Giwerc MY, Staib L, Etesami M. Breast Cancers Detected during a Decade of Screening with Digital Breast Tomosynthesis: Comparison with Digital Mammography. Radiology. 2024 Sep;312(3):e232841. doi:10.1148/radiol.232841. PMID: 39287520.
2. National Institute on Aging – https://www.nia.nih.gov/
3. U.S. Preventive Services Task Force – Osteoporosis Screening Recommendation
   https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/osteoporosis-screening
4. Bone Health & Osteoporosis Foundation – General Facts
   https://www.bonehealthandosteoporosis.org/preventing-fractures/general-facts/what-women-need-to-know/
5. CDC – Women and Heart Disease
   https://www.cdc.gov/heart-disease/about/women-and-heart-disease.html
6. Atherosclerotic Cardiovascular Disease Review – https://doi.org/10.1148/rg.210122
7. Greenland P, Blaha M, Budoff M, et al. Coronary Calcium Score and Cardiovascular Risk. JACC. 2018 Jul;72(4):434–447. doi:10.1016/j.jacc.2018.05.027
8. Clinical Lung Cancer Journal – Smoking in Women
   https://www.clinical-lung-cancer.com/article/S1525-7304(23)00212-7/fulltext
9. Bruder C, Bulliard JL, Germann S, Konzelmann I, Bochud M, Leyvraz M, Chiolero A. Estimating lifetime and 10-year risk of lung cancer. Prev Med Rep. 2018;11:125–130. doi:10.1016/j.pmedr.2018.06.010
10. American Cancer Society – LDCT Guidelines
    https://acsjournals.onlinelibrary.wiley.com/action/showCitFormats?doi=10.3322/caac.21811