Task force lowers breast cancer screening age to 40

Starting at age 40, women should get a mammogram to screen for breast cancer every other year, according to new recommendations from the U.S. Preventive Services Task Force. 

Earlier guidance from the task force recommended women in their 40s "make an individual decision" with their physician on when to start screening, with a firm recommendation to start biennial mammograms no later than 50. The USPSTF is an independent panel of experts that develops recommendations for preventive services, which insurers typically follow in determining coverage and reimbursement plans. 

The change comes as cancer rates rise among younger adults. 

"More women in their 40s have been getting breast cancer, with rates increasing about 2 percent each year," Wanda Nicholson, MD, chair of the task force and senior associate dean for diversity, equity and inclusion at the Milken Institute School of Public Health at George Washington University Washington, said in a statement. She added that the updated guidance is expected to save 20% more lives overall.  

The USPSTF classified the recommendation to begin breast cancer screenings at age 40 as grade "B," meaning, "There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial." The Affordable Care Act mandates insurance companies cover services with a grade B" or higher recommendation. 

The American Cancer Society said the changes are now more consistent with its own guidelines — a recommendation of mammograms every year for women ages 45 to 54, with an option to switch to biennial cadence starting at 55 — though it said it is disappointed the updated screening guidance does not include women over the age of 74. 

"Millions of women over age 75 are in very good health and are expected to live many more years during which their risk of breast cancer remains high," the group said. "The ACS does not support stopping screening for anyone with a 10+ year life expectancy irrespective of age." 

The task force said more research is needed on the harms and benefits of screening and treatment in women 75 and older. The group called on the research community to prioritize studies among this population, in addition to research on whether additional screening with an MRI should be recommended for women with dense breast tissue, and on how to reduce disparities in access to screenings and treatment. 

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