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ACS supports lowering of the age of screening commencement in updated USPSTF breast cancer screening recommendation

New recommendations more closely match ACS guidelines.

The US Preventive Services Task Force (USPSTF) recently released new, draft recommendations for breast cancer screening which lower the age to begin biennial screening from age 50 to age 40. The American Cancer Society views these draft recommendations as a significant, positive change as they now include a direct recommendation for screening women in their 40s.

This is important news, as the independent, volunteer panel’s recommendations are influential in health care-related decisions in the US. With the proposed changes, the USPSTF recommendation for regular mammography screening every two years is extended to women ages 40-49. This means the USPSTF joins the ACS in recommending breast cancer screening begin before age 50, but still the guidance from the two organizations is different, as shown in the chart below.

The ACS breast cancer guidelines are a hybrid model of annual screening from age 45 - 54, and biennial screening from age 55 onward. These guidelines were last updated in 2015 and are being updated now. 

“We applaud the return in USPSTF recommendations to begin screening in their 40s,” said Dr. William Dahut, chief scientific officer. “However, further consideration may be required as to the frequency of screening for women under age 55. Current evidence indicates that biennial screening in this population is associated with a diagnosis of more advanced disease.” 

ACS guidelines

USPSTF draft recommendations

Women at average risk: 

Age 40: begin optional annual screening

Age 45: begin annual screening

Age 40: begin biennial screening

Age 55: may begin biennial screening or continue annual screening. 

Women should continue screening
as long as they are in good health
and are expected to live at least 10 more years.

(no specific recommended age to stop screening)

Continue screening until age 74

Breast cancer is the second most common cancer and the second most common cause of cancer death for women in the US. Mammography continues to be the best primary tool to detect breast cancer and save lives.

“Cancer screening and early detection are critical components of ending cancer as we know it, for everyone,” said CEO Dr. Karen Knudsen. “However, equitable access to high-quality cancer care (downstream of a diagnosis) is essential to eradicate cancer disparities. Our advocacy affiliate, ACS CAN, will continue to support and advocate for everyone for whom it is recommended to have access to coverage of breast cancer screening services ― including supplemental screening and follow-up testing – with no cost-sharing which will help improve both access and outcomes.”

Dr. Knudsen also noted the task force’s recommendations do not apply to people with a personal history of breast cancer, or to those at very high risk of the disease. “ACS will continue to fund research to better understand needed screening and early detection for those at high risk,” she said.

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