A little history for the non-US readers: the U.S. Preventive Services Task Force (USPSTF) is an independent panel that reviews evidence and issues recommendations for preventive health care services. They are sponsored by the U.S. Agency for Healthcare Research and Quality (AHRQ) but the panelists are physicians, nurses, and public health researchers employed by universities and state health departments.
From 1989-2002, annual screening mammography was recommended for women at low risk of breast cancer starting at age 50 in the US. In 2002, USPSTF changed that recommendation to recommend mammography every 1-2 years for women starting at age 40. This change was scientifically contentious – there were questions about the data – but endorsed by cancer organizations. This month, USPSTF changed the recommendation back to starting at age 50. You can read the published recommendation here. This change is less scientifically contentious, but has been even more upsetting to cancer organizations and, in many cases, to women.
I’m going to tackle just a few of the key decision making questions here to try to clarify what’s going on. For example, I’m going to set aside questions of cost and of insurance coverage, which are significant issues, to focus only on the health questions, and only on women at low risk for breast cancer.
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