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The American Cancer Society now advises women to start mammograms at 45, not 40

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The American Cancer Society updated its mammogram guidelines today, recommending that most women should start receiving annual screenings for breast cancer at age 45 instead of the previous age of 40. The health organization also says that women should switch to getting mammograms every other year when they reach age 55. Finally, the ACS has decided that women should no longer receive breast exams — either from a medical provider or ones that are self-administered.

The new recommendations, published today in the Journal of the American Medical Association, are based on a systematic review of the research surrounding breast cancer screenings. They more closely resemble the guidelines issued by the US Preventive Services Task Force (USPSTF), an independent panel of health experts appointed by the US Department of Health. In 2009, the USPSTF stopped recommending screenings for women between the ages of 40 and 50, and switched to recommending mammograms every other year when they reach age 50. The change was met with criticism from many health groups, including the ACS, with some experts claiming that more women would die from breast cancer.

The goal is to boost the benefits of mammograms while minimizing the risks

Now the ACS is updating its recommendations, as well, based on new evidence published since 2009. The goal of the changes is to boost the benefits of mammograms while minimizing the risks associated with the procedure, according to the organization. Mammograms often run the risk of turning up false positives, indicating cancerous cells that are actually benign. These false-positive results must be followed up with more testing, such as biopsies and MRIs, which can be painful or damaging to a patient's health.

The more mammograms a woman has, the greater her risk of getting a false positive. And studies show that a woman's cumulative risk of a false positive is much greater if she starts breast cancer screenings at a younger age, according to the ACS. Additionally, the risk of breast cancer is greater for women aged 45 to 54, compared with those between 40 and 45, prompting the new age recommendations.

"We know that debates will continue about the age to start mammography," said Richard Wender, the American Cancer Society's chief cancer control officer. "This guideline makes it so clear that all women by age 45 should begin screening – that’s when the benefits substantially outweigh the harms."

The ACS acknowledges that women may still want to get annual mammograms when they turn 40, despite the increased chance of false positives. Because of this, the organization says that women should be able to start regular screenings at 40 if they want. Women who want to continue with annual exams after reaching age 55 should also be able to do so, although research indicates that biennial checkups provide the same amount of benefits as annual checkups. Breast exams were also dropped under the new ACS guidelines as they do "not show they provide a clear benefit."

The ACS is the latest major health organization to recommend less screenings for cancer. The American College of Physicians changed its cervical cancer screening guidelines in April, advising women over the age of 21 to get a pap smear once every three years instead of annually. And in May, the American Urological Association said that men should get regularly screened for prostate cancer between the ages of 55 and 69, while men between ages 40 and 54 don't need routine screening.