Breast Cancer Screening Now Starts at 40: What the 2024 USPSTF Update Means

What people see in the news

In 2024, headlines announced that a national panel now recommends women start regular mammograms at age 40 rather than 50. The change came from the U.S. Preventive Services Task Force (USPSTF), an independent group of experts whose recommendations often influence what insurers cover.

What it actually means

On April 30, 2024, the USPSTF issued its final recommendation that women at average risk get screened for breast cancer with a mammogram every other year, starting at age 40 and continuing through age 74. This carries a "B" grade, which means the Task Force concluded there is moderate certainty of a moderate net benefit.

The shift matters because the previous USPSTF guidance had recommended routine screening begin at 50 for most women, with the decision to start in the 40s left to the individual. Starting a decade earlier, the Task Force estimated, could reduce breast cancer deaths compared with the older approach. The American Cancer Society welcomed the change, noting it brings the USPSTF closer to ACS guidance, which also supports the option of annual screening beginning at 40.

According to the National Cancer Institute, screening mammography has been shown to reduce deaths from breast cancer among women ages 40 to 74, and expert groups generally recommend that women begin breast cancer screening at age 40. Mammography uses low-dose x-rays to create pictures of the breast and can sometimes detect abnormal tissue, including cancer, before symptoms appear.

What this does and doesn't change

• It is a recommendation about average-risk women. People with a strong family history, known genetic risk, or prior chest radiation may be advised to start earlier or add other tests — that is an individual conversation.
• The USPSTF recommends screening every other year. Some groups, including the ACS, offer the option of annual mammograms. The "right" interval is an area of ongoing discussion, not settled fact.
• NCI is candid that screening has both benefits and harms. Possible harms include false-positive results, follow-up tests, and overdiagnosis (finding a cancer that would never have caused problems). Lowering the start age means more screening overall, which increases both the cancers found and these downsides.

If you're wondering where you fit, our free screening check-up tool can help you organize a conversation with your clinician, and our overview of mammograms explains what to expect.

Questions to ask a healthcare team

• Based on my age and risk factors, when should I start mammograms, and how often?
• Am I average risk, or is there a reason to consider earlier or additional screening?
• What are the benefits and possible harms of screening in my situation?
• What happens if a mammogram finds something that needs a closer look?

Guideline updates can sound alarming, but they usually reflect careful weighing of benefits and harms. Free, plain-language cancer education helps more people make sense of what a change actually means for them.