USPSTF to Revisit Breast Screening Guidelines

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The U.S. Preventive Services Task Force (USPSTF) has announced a draft research plan for updating its 2009 breast cancer screening recommendations and is seeking public comment on that plan.

According to the USPSTF website, all screening recommendations are reviewed every five years and the timing of this review is not related to the controversy that developed after the 2009 recommendations were issued. In 2009, the USPSTF changed their mammography recommendations from annual screening to bi-annual screening and downgraded mammography for women 40 to 49 years old to grade C, meaning the benefit of screening this population was small.

Although the USPSTF was careful to say it did not recommend against annual screening and screening in women 40 to 49, its conclusion that the benefit was small helped shape payor policies.

Since 2009, when the USPSTF changed its mammography recommendations, additional studies have documented benefits related to annual screening and screening starting at 40. Plus, the screening landscape has changed with, new modalities such as breast tomosynthesis, come into wider use and 13 states passing laws requiring mammography providers to share breast density information with patients.

The current 16-member volunteer task force is headed by Virginia A. Moyer, M.D., M.P.H., vice president of Maintenance of Certification and Quality for the American Board of Pediatrics, Chapel Hill, NC. It does not include a radiologist.

There are seven steps to issuing a recommendation:

1. Develop research plan
2. Finalize research plan
3. Develop evidence report
4. Develop recommendation
5. Public comment opportunity
6. Finalize recommendation and evidence report
7. Publish and disseminate final recommendation

The public can review the draft research plan and submit comments confidentially from now until December 11 via the Task Force Web site.

Read the full 2009 Task Force recommendation statement on screening for breast cancer.