Biennial Breast Screening Starting at 40 Saves Black Lives

Moving the age of biennial breast cancer screenings of Black women to 40 could cut cancer deaths by 57% compared with White women, according to a model study of US women born in 1980 published in the Annals of Internal Medicine.

The study team, led by Dr. Christina Chapman of Georgetown University, summarized their results: “Biennial screening from ages 45 to 74 years was most efficient for Black women, whereas biennial screening from ages 40 to 74 years was most equitable. Initiating screening 10 years earlier in Black versus White women reduced Black–White mortality disparities by 57% with similar LYG [life-years gained] per mammogram for both populations. Selection of the most equitable strategy was sensitive to assumptions about disparities in real-world treatment effectiveness: The less effective treatment was for Black women, the more intensively Black women could be screened before tradeoffs fell short of those experienced by White women.”

“Initiating biennial screening in Black women at age 40 years reduces breast cancer mortality disparities and yields benefit–harm ratios that are similar to tradeoffs of White women screened biennially from ages 50 to 74 years,” concluded the team.


Christina Hunter Chapman, Clyde B. Schechter, Christopher J. Cadham, et al. Identifying Equitable Screening Mammography Strategies for Black Women in the United States Using Simulation Modeling. Ann Intern Med. [Epub ahead of print 19 October 2021]. doi:10.7326/M20-6506. Available online at Accessed October 31, 2021.

Allegretto, Amerigo. Starting biennial breast screening at age 40 saves Black lives. October 18, 2021, at Accessed October 31, 2021.