NEWS

Mammograms Should Begin at Age 40, USPSTF Says

A mature African-American woman in her 40s wearing a hospital gown, getting her annual mammogram. She is being helped by a technologist, a blond woman wearing scrubs.

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Key Takeaways

  • New USPSTF guidelines recommend mammograms for women starting at 40.
  • Previous recommendations said women aged 40-50 should make an individual decision with their clinician on whether they should start screening.
  • A steady increase in breast cancer cases in women in their 40s is the root cause of the updated guidelines.

Mammograms for women who turn 40 became a priority again this week after the U.S. Preventive Task Force (USPSTF) updated their guidelines recommending all women start getting screened for breast cancer at the age of 40 and continue every other year until age 74.

Previous guidelines recommended women speak with their providers about whether or not to begin screening before age 50—now, USPSTF says all women should start at 40.

An increase in younger women developing early-onset (younger than 50) breast cancer is the driving force behind the update. Earlier screenings will save more lives, especially among Black women, who are 40% more likely to die of breast cancer.

“Based on a couple lines of evidence, including an epidemiology study, women being diagnosed with breast cancer in their 40s has been steadily increasing by 2% a year,” USPSTF chair Carol Mangione, MD, a professor of medicine and public health at UCLA, told Verywell. “Early screenings at age 40 can save about 20% more lives.”

The new USPSTF guidelines also say there is insufficient evidence on the most effective way to screen dense breast tissue. Half of women have dense breast tissue, which makes it harder for a mammogram to detect potential tumors.

A Note on Gender and Sex Terminology

Verywell Health acknowledges that sex and gender are related concepts, but they are not the same. To reflect our sources accurately, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.

Why Every Other Year?

With early-onset breast cancer cases on the rise, many are wondering why the guidelines recommend screening every other year as opposed to an annual screening. The USPSTF said its decision is based on the balance between risk and benefit. A major risk is false-positive results, which occur in about 50% of women—especially those who are younger.

“It is something we looked into very carefully,” Mangione said. “We looked at different modeling studies and we found the benefit of screening every year does not outweigh the harm from false positive results.”

While getting a false positive might not sound like a big deal, Mangione highlights the negative toll it can take on a person who receives an incorrect diagnosis. These negative outcomes can include:

  • Stress and anxiety
  • Unnecessary biopsies 
  • Overdiagnosis (leading to unnecessary treatment)

Will Insurance Cover Mammograms for People in Their 40s?

The new guidelines not only recommended screening start at age 40; they also changed the grade of the recommendation from a grade C to a grade B for that age group. This impacts how insurance companies respond. If you have health insurance and are in your 40s or older, your mammogram should be covered.

  • Grade B: The USPSTF recommends the service. There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial. Practices should offer or provide this service.
  • Grade C: The USPSTF recommends selectively offering or providing this service to individual patients based on professional judgment and patient preferences. There is at least moderate certainty that the net benefit is small. Practices have a choice to offer the service for individual patients.

While this upgrade ensures that insurance companies pay for mammograms starting at age 40, the Affordable Care Act actually already introduced this requirement. Breast cancer services, including mammograms, need to be covered by all private insurance companies and Medicaid for women ages 40 to 74 with an average risk for breast cancer.

What This Means For You

In order to catch early-onset breast cancer, women should start getting mammograms at age 40. 

While the USPSTF recommendations state that screenings should be done every other year, you should talk with your primary care physician about your specific circumstances to determine if an annual exam is beneficial, including the possibility of secondary imaging if you have dense breast tissue. 

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. US Preventive Services Task Force, Nicholson WK, Silverstein M, et al. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. Published online April 30, 2024. doi:10.1001/jama.2024.5534

  2. American Cancer Society. Breast cancer death rates are highest for black women—again.

  3. Koh B, Tan DJH, Ng CH, et al. Patterns in cancer incidence among people younger than 50 years in the US, 2010 to 2019. JAMA Netw Open. 2023;6(8):e2328171. doi:10.1001/jamanetworkopen.2023.28171

  4. American Cancer Society. Breast density and your mammogram report.

  5. Susan G. Komen. Accuracy of mammograms.

  6. U.S. Preventive Services Task Force. Grade definitions.

  7. KFF. Coverage of breast cancer screening and prevention services.

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By Amy Isler, RN, MSN, CSN
Isler is a registered nurse with over six years of patient experience. She is a credentialed school nurse in California.