Regular mammograms to screen for breast cancer should start as early as age 40, according to an influential US task force. Women ages 40 to 74 should get tested every two years, the group said.
Previously, the working group had said that women could choose to start breast cancer screening from the age of 40, with a stronger recommendation that they undergo screenings every two years from the age of 50 to 74.
Tuesday’s announcement by the U.S. Preventive Services Task Force formalizes a draft recommendation announced last year. The recommendations were published in the Journal of the American Medical Association.
“It’s a victory that they are now recognizing the benefits of screening in women in their 40s,” said Dr. Therese Bevers of MD Anderson Cancer Center in Houston. She was not involved in the guidance.
Other medical groups, including the American College of Radiology and the American Cancer Society, suggest mammograms every year — rather than every two years — starting at age 40 or 45, which can cause confusion, Bevers said, but “now the starting age will align.” with what many other organizations are saying.”
Breast cancer death rates have fallen as treatment continues to improve. But breast cancer is still the second most common cause of cancer death in American women. Around 240,000 cases are diagnosed annually and almost 43,000 women die from breast cancer.
Encouraging earlier screening is intended to address two vexing issues: the rising incidence of breast cancer among women in their 40s – it has increased by 2% annually since 2015 – and the higher breast cancer death rate among black women compared to white women, Task said. force vice president Dr. John Wong of Tufts Medical Center in Boston.
“Unfortunately, we know very well that black women are 40% more likely to die from breast cancer than white women,” Wong said. Modeling studies predict that early screening could help all women and bring “even more benefits to women of color,” he said.
Here are more details on what’s changed, why it matters, and who should pay attention.
Age 40 is when mammograms should begin for women, transgender men, and non-binary people at average risk. They must have an X-ray exam every two years, according to the new guidance. Other groups recommend annual mammograms starting at age 40 or 45.
The advice does not apply to women who have had breast cancer or who are at very high risk of breast cancer due to genetic markers. It also does not apply to women who received high-dose radiotherapy to the chest when they were young, or to women who had a lesion on previous biopsies.
It’s unclear whether older women should continue to have regular mammograms. Studies rarely include women aged 75 and over, so the working group calls for more research.
Bevers suggests that older women talk to their doctors about the benefits of screening, as well as the harms, such as false alarms and unnecessary biopsies.
Mammograms don’t work as well for women with dense breasts, but they should still get tested.
The task force would like to see more evidence about additional tests, such as ultrasound or MRI, for women with dense breasts. It’s not yet clear whether these types of tests would help detect cancer at an earlier, more treatable stage, Wong said.
Congress has already passed legislation that requires insurers to pay for mammograms for women ages 40 and older, with no copays or deductibles. Additionally, the Affordable Care Act requires insurers to cover the task force’s recommendations with an “A” or “B” grade. The mammogram recommendation has a grade of “B,” meaning it has a moderate net benefit.
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