New recommendations from the US Preventive Services Task Force advise women to get a mammogram every other year starting at age 40 and continuing until age 74. This is a change from their previous recommendation of starting biennial mammograms at age 50, with screening in the 40s being an individual decision.
Published in JAMA, these updated guidelines apply to all individuals assigned female at birth, including cisgender women, transgender men, and nonbinary individuals at average risk of breast cancer, as well as those with a family history of the disease or dense breasts. However, they don’t apply to individuals with a personal history of breast cancer, genetic markers for high risk, or a history of high-dose radiation therapy to the chest or high-risk breast lesions.
The shift towards starting screening at age 40 is based on recent evidence indicating that earlier mammograms can reduce breast cancer deaths. This is significant as breast cancer ranks second in cancer occurrence and death among women in the US.
However, not all experts agree with the biennial recommendation. Some argue that annual screening may be more effective, especially for premenopausal women and those in racial and ethnic minority groups. Additionally, concerns are raised about the task force’s approach to individuals with different risk factors for breast cancer, such as dense breasts or family history.
Critics worry that the new recommendations might limit access to screening and result in more late-stage diagnoses, which are harder and costlier to treat. They emphasize the importance of individualized screening decisions based on personal and family medical history.
The task force defends its recommendation, stating that biennial screening strikes a balance between benefits and harms. They highlight that annual screening can lead to more false positive results, which can cause unnecessary anxiety and interventions.
Overall, the recommendations aim to improve breast cancer detection while minimizing harm. However, ongoing research is needed to address disparities in breast cancer outcomes, particularly among underserved communities, and to ensure equitable access to screening technologies and high-quality care.
