American College of Physicians Recommends Biennial Mammograms for Women 50-74 as U.S. Groups Split on Starting at 40
Updated
Updated · NBC News · May 16
American College of Physicians Recommends Biennial Mammograms for Women 50-74 as U.S. Groups Split on Starting at 40
2 articles · Updated · NBC News · May 16
Average-risk women ages 50 to 74 should get mammograms every other year, the American College of Physicians said, while women 40 to 49 should weigh benefits and harms with a doctor before choosing the same schedule.
The guidance diverges from other major U.S. groups: the U.S. Preventive Services Task Force now starts biennial screening at 40, and the American Cancer Society recommends annual exams from 45 to 54, with an option to begin at 40.
Nearly half of women over 40 have dense breasts, which can both obscure tumors and slightly raise cancer risk; ACP says 3D mammography should be considered, while evidence for adding ultrasound or MRI remains unclear.
More than 320,000 U.S. women are expected to be diagnosed with breast cancer this year, and researchers are testing risk-based screening that uses genetics, health history and breast density instead of one schedule for everyone.
A recent WISDOM trial of nearly 46,000 women found tailored screening performed as well as standard annual mammograms, pointing toward future guidelines that may personalize when to start and how often to screen.
With top medical groups offering conflicting advice, how can women decide on the right mammogram schedule for them?
As AI learns to predict breast cancer risk, are traditional age-based mammogram schedules now obsolete?
2026 Breast Cancer Screening Guidelines: ACP’s Biennial Shift, Conflicting Recommendations, and the Future of Personalized, AI-Based Screening
Overview
In April 2026, the American College of Physicians (ACP) released new breast cancer screening guidelines for asymptomatic, average-risk adult women, published in the Annals of Internal Medicine and presented at a major scientific meeting. Developed by a team of experts and informed by new data, these guidelines mark a shift toward biennial screening, aiming to balance early cancer detection with the potential harms of over-screening. Experts describe the recommendations as thoughtful and comprehensive, reflecting a careful review of diverse evidence. The ACP’s update highlights the importance of individualized, evidence-based care in breast cancer screening.