USPSTF Proposed Breast Screening Guidelines: PALS Coalition Statement

May 12, 2023

The Protecting Access to Lifesaving Screening (PALS) Coalition is pleased to see the United States Preventive Services Task Force (USPSTF) propose to recommend that women begin breast cancer screening mammography starting at age 40.

The proposed change to start screening mammography at age 40 is an important acknowledgement that, while most women develop breast cancer later in life, young women do develop this horrible disease, often developing rapidly in more aggressive forms.  And, as the USPSTF statement notes, “Black women are 40 percent more likely to die of breast cancer than White women and too often get deadly cancers at younger ages.”  The need for earlier screening and diagnosis is greater for women with inherited mutations associated with increased risk of cancer, such as the BRCA genes, and for Ashkenazi Jewish women, Black, and Latina women, and women who were treated with radiation therapy for cancer as children or young adults.

Screening mammography saves lives, which is why we are disappointed in the proposed recommendation to retain every other year interval, especially because the USPSTF’s new modeling report finds that annual screening saves more lives than screening every two years.  The USPSTF also makes a proposed recommendation on secondary screening for women with dense breasts.  The advances in our understanding of dense breasts and the increased incidence of women with dense breasts have strengthened the importance of secondary screening and need for coverage with no patient cost-sharing – critically important issues for the USPSTF to reconsider.

The drop in cancer screening in the past several years due to the pandemic was especially severe with respect to breast cancer screening, where rates declined by as much as 87% according to data in 2022.  As we work to urge women to “catch up” on their screenings, we must acknowledge that low breast cancer screening rates existed before the pandemic, notably among women living in rural areas and women of color.  We know we can do better, particularly because there are proven methods of early detection, but only if women are screened.  Ensuring accurate and clear screening guidelines is a key component and the goal of all of our organizations.

The PALS Act Coalition is an informal group of organizations united in support of the Protecting Access to Lifesaving Screening (PALS) Act which has protected access to annual breast screening mammography coverage with no co-pay for women ages 40-49 and more broadly is dedicated to advancing preventive breast cancer screening.  The current PALS Act expires January 1, 2025.

The PALS Act Coalition includes:

American College of Radiology                                      American Women Unite for Breast Cancer Screening

Black Women’s Health Imperative                                Breast Care for Washington

Breast Friends                                                                    Brem Foundation

Bright Pink                                                                           Check for a Lump

DenseBreast-info, Inc.                                                      FORCE: Facing Our Risk of Cancer Empowered

Living Beyond Breast Cancer                                          Men Supporting Women With Cancer

National Black Nurses Association                                 National Consortium of Breast Centers

National Medical Association                                         Prevent Cancer Foundation

Rye Radiology                                                                    Sharsheret                                                                                                                                          Society of Breast Imaging                               Susan G. Komen

Tigerlily Foundation