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May 01, 2024

Breast cancer screenings should begin at 40, new guidelines say

The U.S. Preventive Services Task Force previously had recommended women start getting mammograms at 50.

Women's Health Cancer
Breast Cancer Screenings Rui Vieira/PA Images; Alamy Images; Sipa USA

The U.S. Preventive Services Task Force now recommends women begin getting breast cancer screenings every other year at age 40.

An expert panel now says that women should begin getting mammograms at age 40, reversing its previous guidance that most women hold off until 50. 

The U.S. Preventive Services Task Force finalized its updated guidelines on breast screenings Tuesday. Its recommendation that women get undergo screenings every other year from age 40-74 brings it in line with guidance from the American Cancer Society and other organizations. 

Health insurers already are required to cover mammograms for women in their 40s, but this recommendation cements coverage under the Affordable Care Act beyond 2025.

The influential panel, which helps set screening guidelines in the U.S., said the change was spurred by an increased number of breast cancer diagnoses among young women. Breast cancer rates among women in their 40s increased by about 2% per year between 2015 and 2019. 

"By starting to screen all women at age 40, we can save nearly 20% more lives from breast cancer overall," Task Force Chair Dr. Wanda Nicholson said. "This new approach has even greater potential benefit for Black women, who are much more likely to die of breast cancer."

Black women are 40% more likely to die from breast cancer. Earlier screenings is "an important first step" toward improving racial disparities in breast cancer, the task force said.  

The task force, which is made up of 16 medical professional appointed by the U.S. Health and Human Services secretary, did not recommend additional screenings for women with dense breasts, saying more studies are needed to determine whether additional screenings via ultrasound or MRI are beneficial. Nearly half of women have dense breasts, which increases the risk of cancer. 

The American College of Obstetricians and Gynecologists and the National Comprehensive Cancer Network also have recommended that women begin screenings in their 40s. 

The task force previously said that women could begin receiving screenings in the 40s based on their health histories and preferences, but did not recommend them until women turned 50. That guidance was criticized as too confusing for doctors and patients. 

"We need to know how best to address the health disparities related to breast cancer so all women can live longer and healthier lives," Task Force Vice Chair Dr. John Wong said. "Clinicians must help reduce any barriers to patients getting the recommended screening, timely, equitable and appropriate follow-up and effective treatment of breast cancer."

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