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New Guidance Says Breast Cancer Screenings Should Start at 40 — Here’s Why

Plus, how to get insurance approval.


Earlier this week, the US Preventive Services Task Force (USPSTF) issued new guidance on breast cancer screenings: Women should get mammograms every other year starting at age 40. That’s a 10-year difference compared to the previous guidance, which was updated in 2016, and recommended starting at age 50.

The USPSTF is an independent organization, so this recommendation is not yet an official government policy. Still, the USPSTF is aiming to change the current policy with the new information. Below, learn why the recommendation changed and how to get coverage if you want to start annual screenings now.

Why did the recommendation change?

“New and more inclusive science about breast cancer in people younger than 50 has enabled us to expand our prior recommendation and encourage all women to get screened in their 40s,” a statement from the USPSTF reads. “We have long known that screening for breast cancer saves lives, and the science now supports all women getting screened, every other year, starting at age 40.”

Other organizations have also strongly recommended that the starting age for screenings drop to 40, citing new research. For instance, the American College of Radiology notes that one in six breast cancers occurs in women in their 40s. In addition, three in four women diagnosed with breast cancer have no family history of the disease and are not considered high risk.

Are mammograms every other year enough?

The USPSTF admits that these new guidelines don’t cover everything. “Black women are 40 percent more likely to die from breast cancer than White women and too often get aggressive cancers at young ages,” the statement reads. “Ensuring Black women start screening at 40 is an important first step, yet it is not enough to improve these inequities.” In addition, women with dense breasts have a greater risk of breast cancer, and mammograms are less likely than MRIs to catch cancer in dense breasts. Nearly half of all women have dense breasts, so more research proving the benefits of other routine screenings (like ultrasounds and MRIs) is crucial.

Furthermore, some radiologists believe the guidance should be to screen every year, not every other year. “They’re taking a step in the right direction, but I do worry about the every-other-year timing,” said Dr. Melissa Durand, an associate professor at the Yale School of Medicine. “Annual screening is going to catch the most amount of cancers when they’re at their smallest sizes and when treatment can be most effective. We will miss cancers if we screen every other year.”

What about insurance?

According to the CDC, most health insurance plans are required by law to fully cover breast cancer screenings every two years, starting at 40 years old. That means you shouldn’t be charged a penny for the visit — no co-pays, deductibles, or co-insurance. If you are younger than 40, you may be on the hook, but there are workarounds. Some states, like New York and Pennsylvania, have laws that require insurers to fully cover annual mammograms (regardless of your age) if you have a history of breast cancer or you have a first-degree relative with a history of breast cancer.

Also, the CDC funds an early detection program for breast and cervical cancer screenings. You may be eligible for a free or low-cost screening if:

  • You have no insurance, or your insurance does not cover screening exams.
  • Your yearly income is at or below 250 percent of the federal poverty level.
  • You are between 40 and 64 years of age (for a breast cancer screening).
  • You are between 21 and 64 years of age (for a cervical cancer screening).

You may also qualify if you are younger or older than those age limits and have certain traits, such as a history of breast cancer.

While this isn’t a comprehensive solution by any means, it’s a start. If you’re ready to start screenings, talk with your gynecologist or primary care physician. She or he will help you make an appointment, or possibly give you a referral if you are under 40 years old.

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.

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