U.S. Task Force Lowers Recommended Age for Breast Cancer Screening to 40

The U.S. Preventive Services Task Force (USPSTF) has updated its cancer screening recommendations, now recommending that women at average risk begin getting mammograms every other year starting at age 40. This is a significant change from the previous recommendation of starting biennial screening at age 50.

The task force cited rising breast cancer rates among women in their 40s and evidence that earlier screening can save lives as the reasons for the updated screening guidelines. The USPSTF estimates that if all women followed this new recommendation, it could reduce breast cancer mortality in the U.S. by about 20%, saving around 8,000 lives per year.

Why this matters: The change in screening guidelines is particularly important for Black women, who are 40% more likely to die from breast cancer compared to white women. Starting screening at age 40 could help address this health disparity and save more lives.

The new recommendations apply to cisgender women and those assigned female at birth between the ages of 40 and 74 with average risk. They do not apply to women with a personal history of breast cancer, those at very high risk due to genetic mutations, or those with a history of high-dose radiation therapy to the chest.

Some medical organizations, such as the American Cancer Society, have already been recommending that women begin regular screening at age 40. However, the USPSTF's recommendations carry significant weight, as the Affordable Care Act mandates that insurers cover preventive services given a grade A or B rating by the task force without copays or deductibles.

While the updated guidelines represent progress in early detection, some experts argue that they do not go far enough. "Annual screening is more effective at reducing late-stage disease and deaths, especially for Black women and those with fast-growing cancers," said Dr. Debra Monticciolo, chair of the American College of Radiology's Breast Imaging Commission.

The USPSTF acknowledged that more research is needed on screening for women over 75 and on supplemental screening methods like ultrasound and MRI for women with dense breasts. The task force also called for more studies to better understand how to tailor screening based on individual risk factors.

The updated USPSTF guidelines bring the U.S. recommendations closer to screening recommendations in other countries. In the UK, for example, the National Health Service offers mammograms every three years to all women aged 50 to 71, with high-risk women able to start screening earlier.

As the new guidelines are implemented, it will be important to ensure equitable access to screening and follow-up care for all women. Efforts to raise awareness about the importance of early detection, especially among underserved communities, will also be critical in reducing breast cancer deaths nationwide.

Key Takeaways

• USPSTF recommends women start mammograms at 40, every 2 years, to reduce mortality by 20%.
• New guidelines aim to address racial disparities, as Black women are 40% more likely to die from breast cancer.
• Recommendations apply to cisgender women and those assigned female at birth with average risk.
• USPSTF calls for more research on screening for women over 75 and supplemental screening methods.
• New guidelines bring US closer to screening recommendations in other countries like the UK.