With new guidelines expanded to include women as young as 40, we looked into how many women in this younger age group were already screened and why.
In April 2024, The U.S. Preventive Services Task Force revised its guidance for breast cancer screening, recommending that women at average risk of breast cancer begin routine biannual mammograms at age 40. This update marks a reversal from 2009, when the task force controversially raised the recommended age to 50, citing concerns that earlier screening would do more harm than good. The recent change reflects a rising incidence of breast cancer among women in their 40s (a 2% annual increase between 2015 and 2019) and persistently high mortality rates, particularly among Black women.
The new guideline’s recommendation for screening every two years remains controversial. Some women’s health advocates argue that more frequent screenings are necessary, along with special care recommendations for women with dense breast tissue. Alternatively, since 2015, the American Cancer Society (ACS) has been recommending that women at average risk for breast cancer begin annual mammograms at age 45.
Between 2016 and 2023, 18% of women ages 40 to 44 received mammograms.
This rate is nearly double for women ages 45 to 49, at 33%, and and even higher — 37% — for women ages 50 to 54. Women in their early 40s had about 65% more mammograms than those in their late 40s (3.5 million vs. 5.9 million, respectively).
Both screening groups fell outside the previous task force guidelines, however, which at the time recommended starting screenings at age 50. Women ages 45 to 50 were within the American Cancer Society's guidelines, which recommended starting screening earlier, at 45, until the change earlier this year.
Among women ages 40 to 44 who were newly diagnosed with breast cancer, approximately half had received a mammogram in the six months prior.
This held true across all age groups. Between 50% and 60% of women diagnosed with breast cancer had received a mammogram in the six months leading up to their diagnosis. The youngest group was only slightly less likely than the older cohorts to have had a mammogram prior to a breast cancer diagnosis (56% vs. 61%, respectively). These rates may approximate the number of women diagnosed as a result of mammogram screening. (Other diagnoses can be made through MRI and ultrasound when women are at higher risk or experiencing symptoms.)
About half of all women with a hereditary predisposition to breast cancer received a mammogram.
Across all age groups, just over half of women who had been diagnosed with a genetic predisposition to breast cancer (most commonly, carriers of the ΒRСA1/2 genes) received a mammogram: 55% of high-risk women ages 40 to 44; 56% ages 45 to 54; and 56% ages 55 to 74. While some women at high risk of breast cancer may undergo other screening procedures, the ACS recommends that all women at high risk receive a breast MRI and a mammogram every year, typically starting at age 30.
Overall, women at high risk made up a fraction of all women who received a mammogram — just over 1% among ages 40 to 44 and less than 1% in older groups.
Screening rates have increased significantly over the past several years.
Leading up to the change in recommendations, the overall number of women having mammograms has risen slightly. We used Komodo’s MapAI tool to find that approximately 22.3 million women had a mammogram in 2016. This number increased by 19% in 2023 to 26.6 million. Of those women, 8% were between ages 40 and 44 in 2016 (2.1 million) compared to 10% in 2023 (3 million) — an increase of 43% over 7 years.
These findings highlight the shifting landscape of breast cancer screenings leading up to the recent guideline change. The insights provided by Komodo’s fit-for-purpose software demonstrates the value of leveraging real-world evidence (RWE) to understand healthcare utilization. High-fidelity data tools like MapAI offer accessible visibility into screening practices and can help healthcare providers and policymakers alike fine-tune screening programs to ensure they align with the evolving needs of at-risk populations.
Timely and accurate data will be key to informing public health strategies that effectively balance the benefits of early detection with the risks of overscreening. We plan to conduct a follow-up analysis to track the uptake of these new guidelines among women ages 40 to 45 to provide further insights into how these changes impact breast cancer detection and outcomes.
Not all public health risks are tracked closely: Check out our analysis of eye injuries during two recent solar eclipses.
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