The American College of Physicians (ACP) has issued updated guidance on breast cancer screening, recommending that all average-risk women between the ages of 50 and 74 undergo a mammogram every two years. The new clinical guidelines, published in the Annals of Internal Medicine on April 17, 2026, aim to balance the benefits of early detection with the potential harms of over-screening.
For women aged 40 to 49, the ACP advises an individualized approach. It recommends that clinicians discuss the potential benefits and harms of screening with these patients to support a shared decision-making process. The guidance states there is insufficient evidence to recommend for or against screening in this age group for those at average risk.
The ACP also provides recommendations for women with dense breasts, suggesting that supplemental screening with MRI or ultrasound may be considered after a discussion of potential benefits and harms. Furthermore, the guidance recommends discontinuing screening for average-risk women at age 75 or for those with a life expectancy of 10 years or less.
The updated guidelines are based on a systematic review of evidence and differ from some other major medical organizations, which may recommend annual screening or starting at age 40. The ACP emphasizes that its recommendations are intended to inform conversations between patients and their doctors.
