The U.S. Preventive Services Task Force has revised its recommendation on mammograms, stating that women of all ethnic backgrounds who are at average risk for breast cancer should start receiving regular mammograms at age 40 instead of waiting until age 50 to do so. This represents a reversal of a recommendation made in 2009, which advised women to start routine mammograms at age 50. At the time, researchers were concerned that earlier screening could lead to more harm than good, including unnecessary biopsies, but trends have shown a concerning rise in breast cancer diagnoses in younger women, particularly younger Black women.
Reports have shown that the mortality rate for Black women with breast cancer remains persistently high. Black women die from breast cancer at twice the rate of white women of the same age, and the U.S.P.S.T.F. had to carry out studies to determine if there were any specific factors behind the racial disparity. The group also needs further research to determine the factors driving the increase in breast cancer diagnoses in women in their 40s.
The task force’s new recommendation covers over 20 million women in the United States between ages 40 and 49 and calls for annual screenings. It does not apply to those who have had breast cancer before, have genetic mutations that increase their risk for breast cancer, have had previous breast lesions identified, or received high-dose radiation to their chest. These women should consult their doctors about how frequently they should be screened.
The task force emphasized the importance of Black women starting mammograms at age 40, as they are more likely to get aggressive tumors at a young age, and 40 percent more likely to die from breast cancer than white women. However, the task force also pointed out that screening alone will not improve survival rates for Black women, who continue to struggle with delays in getting medical care and life circumstances that make receiving treatment difficult.
The new recommendations reflect a growing urgency around the issue of breast cancer in the U.S. A report from the American Cancer Society revealed that breast cancer diagnoses in women in their 40s had been growing at less than 1 percent between 2000 and 2015 but rose by 2 percent per year on average between 2015 and 2019. Possible reasons behind the increase include the postponement of childbearing and not having children at all.
Breastfeeding and having children before the age of 35 have been shown to reduce the risk of breast cancer. However, there is much year-to-year variation in the rates of breast cancer diagnoses, and researchers are still studying the possible factors that could be contributing to the increased rate of diagnoses in younger women.
While the task force’s new recommendations have been welcomed, some scientists have suggested that a “risk-adapted” method may be more effective, which would mean screening Black women around six to eight years earlier than white women. Meanwhile, the American Cancer Society has suggested that women aged 40 to 44 should be able to choose screening, but starting from the age of 45, they should get mammograms every year until the age of 55 when the risk of breast cancer begins to drop.
