According to ACOG guidelines, when should mammogram screening begin and how long should it continue?

• A. Start at age 40 and continue annually until age 75.
• B. Start at age 50 and continue annually until age 75.
• C. Start at age 40 and continue every other year until age 80.
• D. Start at age 35 and continue annually until age 70.

Answer: (A)

Initiating screening at age 40 and doing it annually through age 75 reflects the balance of benefits and practical considerations for average-risk women. Beginning at 40 allows earlier cancers to be detected when they’re more treatable, and annual screening maximizes the chance of catching cancers in their smaller, earlier stages. Extending the screening up to around age 75 covers the period when many women still have substantial life expectancy and benefit from early detection, while recognizing that once a person’s overall health and life expectancy decline, the net benefit of screening diminishes and decisions should be individualized. Other schedules—starting later, screening less frequently, or stopping earlier—do not align with this guideline.