An expert panel recommended on Tuesday that regular mammography screening should begin at age 40, citing a surge in breast cancer rates among young women. This recommendation marks a reversal of longstanding guidance that advised most women to wait until age 50 for routine screening.
The U.S. Preventive Services Task Force, known for issuing influential advice on preventive health, finalized a draft recommendation made public last year. The decision to lower the screening age reflects concerns over the increasing incidence of breast cancer among women in their 40s, which has been rising by 2 percent annually between 2015 and 2019.
Dr. John Wong, vice chair of the task force, emphasized that the recommendation aims to provide sufficient benefits to help women live longer and improve their quality of life. The panel advises screening every two years for women at average risk of breast cancer, though many patients and providers prefer annual screening.
However, the recommendation has faced criticism from women’s health advocates like Representative Rosa DeLauro and Representative Debbie Wasserman Schultz, who argue that it does not go far enough to address the issue.
In addition to the change in screening age, the task force stated that there was insufficient evidence to endorse extra scans, such as ultrasounds or magnetic resonance imaging, for women with dense breast tissue. This decision has significant implications for insurance coverage, as insurers are not mandated to provide full coverage for additional screening for these women.
The task force’s stance on supplemental imaging has sparked controversy, with some medical organizations like the American College of Radiology endorsing supplementary screening for women with dense breast tissue. They argue that ultrasound, in conjunction with mammography, detects additional cancers in patients with dense tissue.
Dr. Stamatia Destounis, chair of the college’s breast imaging commission, emphasized the importance of annual screening for women at average cancer risk, as opposed to the task force’s recommendation of screening every two years. She also highlighted the need for all women to be assessed for breast cancer risk before age 25 to ensure timely screening for those at high risk.
While the task force’s decision to lower the screening age to 40 is considered an improvement, Dr. Destounis believes that the recommendations do not go far enough to save women’s lives. She emphasized the need for comprehensive screening strategies, especially for minority women and transgender individuals at increased risk of breast cancer.
The task force’s recommendations underscore the ongoing debate surrounding breast cancer screening and the challenges in balancing the benefits of early detection with the potential harms of overdiagnosis and unnecessary treatment. As medical experts continue to refine screening guidelines, the focus remains on improving outcomes for all women at risk of breast cancer.
