Breast cancer screening from age 40 in the US

The US Preventive Services Task Force has updated its recommendation for the age when all women should start mammography screening, lowering it from 50 to 40.1 This change immediately affects more than 20 million American women and other people assigned female at birth who are aged 40-49,2 with repercussions far beyond the US.Such a momentous change should reflect new randomised trial evidence or concerning cancer mortality trends. But no such trial evidence was found in the commissioned evidence report,3 and breast cancer mortality has been decreasing, especially among women under 50.4 The new recommendation seems to be based on two, inter-related, considerations. The first is recognition of the inequality in breast cancer mortality between Black and white US women, and a commitment to reduce this. The second is statistical modelling of a hypothetical population that found starting screening at 40 would reduce breast cancer mortality, especially among Black women.5The need…
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