Current Policy Priority

Proposed Breast Screening Guidelines Miss the Mark

The U.S. Preventive Services Task Force (USPSTF) recently published draft recommendations for breast cancer screening. The proposed guidelines suggest that individuals at average risk of breast cancer should start mammograms at age 40, but only recommend screening every other year. 

FORCE submitted comments, expressing concerns that the proposed guidelines will worsen health disparities, lead to confusion, and cost the lives of women in the community we serve. We encouraged the USPSTF to consider the evidence in support of:

• Annual screening mammograms, beginning at age 40
• Defining “high risk” beginning at age 25 using tools that consider inherited cancer risk and other factors
• Adding additional screening recommendations including breast ultrasound and/or MRI for those at high risk due to an inherited genetic mutation, family history, those with dense breasts and other risk factors

It is important to note that individuals at increased risk of breast cancer such as women of Color, those with an inherited genetic mutation or family history, dense breasts or other factors need more frequent, more intensive screening with breast ultrasound and/or MRI starting at earlier ages. For instance, National Comprehensive Cancer Network (NCCN) guidelines recommend that women with a BRCA mutation begin screening with an annual breast MRI starting at age 25. See the Risk Management Guidelines for more information as recommendations vary for different hereditary mutations.

More Info and History

The USPSTF is a government-supported independent panel of experts that reviews and develops recommendations on preventive health services for the general population. Currently, its recommendations guide which preventive services are covered at no cost to patients under the Affordable Care Act. 

In 2016, the Task Force released Breast Cancer: Screening Recommendations indicating that screening should start at age 50. If those guidelines had been implemented, many women between the ages of 40 and 49 would have lost access to lifesaving breast screenings. 

FORCE was a leader in efforts to curtail those guidelines via the "Stop the Guidelines" campaign and support of the Protecting Access to Lifesaving Screenings (PALS) Act. This law placed a moratorium on changes to the USPSTF breast cancer screening guidelines, maintaining access to annual mammogram screenings with no insurance copay or cost-sharing for women starting at age 40.

The PALS Act will expire January 1, 2025. Unless the law is renewed, the latest USPSTF guidelines may impact access to screening mammograms. FORCE and its partners will work vigilantly to ensure this doesn't happen.