The American College of Radiology recommends annual screening mammography for women starting at age 40. This affords the maximum benefits of reduced breast cancer deaths, less extensive treatments for cancers that are found, decreased chance of advanced disease at diagnosis, and discovery and treatment of high risk lesions. Breast cancer incidence increases substantially around age 40 and even earlier for high risk women and women of color.
All health insurers, including the Centers for Medicare & Medicaid Services (CMS), should cover women ages 40 and older for annual mammograms as a preventive service, without additional cost sharing or co-payments. Extensive scientific research shows a 40 percent reduction of breast cancer deaths with regular mammographic screening. The greatest mortality reduction, the most lives saved and the most life years gained occur with yearly mammography starting at age 40. There is no established age for women to stop screening. Women should continue breast cancer mammography screening as long as they are healthy and desire to remain so. Therefore, health care coverage for screening should not have an upper age limit.
References
- American College of Radiology. Benefits and limitations of mammography. Digest of Council Action 2015-2016: 2002, amended 2012 (Res. 23-c).
- Broeders M, Moss S, Nystrom L, et al. The impact of mammographic screening on breast cancer mortality in Europe: a review of observational studies. J Med Screen 2012; 19 Suppl 1:14-25.
- Coldman A, Phillips N, Wilson C, et al. Pan-Canadian study of mammography screening and mortality from breast cancer. J Natl Cancer Inst 2014; 106(11).
- Helquist BN, Duffy SW, Abdsaleh S, et al. Effectiveness of population-based service screening with mammography for women ages 40-49 years. Cancer 2010;117(4): 714–722.
- Helvie MA, Chang JT, Hendrick RE, et al. Reduction in late-stage breast cancer incidence in the mammography era. Cancer 2014;120(17): 2649-2656.
- Hendrick RE and Helvie MA. Mammography Screening: A new estimate of number needed to screen to prevent one breast cancer death. AJR 2012;198: 723-728.
- Moss S, Nystrom L, Jonsson H, et al. The impact of mammographic screening on breast cancer mortality in Europe: a review of trend studies. J Med Screen 2012; 19 Suppl 1:26-32.
- Njor SH, Nystrom L, Moss S, et al. Breast cancer mortality in mammographic screening in Europe: a review of incidence-based mortality studies. J Med Screen 2012; 19 Suppl 1:33-41.
- Tabár L, Vitak B, Chen TH, et al. Swedish two-county trial: impact of mammographic screening on breast cancer mortality during 3 decades. Radiology 2011; 260(3): 658-663.