WASHINGTONAmid continuing controversy over the effectiveness of
screening mammography for breast cancer, the US Preventive Services Task
Force (USPSTF) has extended its recommendations to include women between the
ages of 40 and 49, after concluding that the procedure reduces breast cancer
In previous screening recommendations issued in 1989 and 1996, the panel
had endorsed mammography for women age 50 and older. Its new report received
added emphasis because it was released personally and strongly supported by
Tommy G. Thompson, secretary of Health and Human Services (HHS).
"When it comes to mammography, the federal government’s
recommendation remains very clear: Women in their 40s and older should be
screened every 1 to 2 years with mammography," said Secretary Thompson,
whose wife Sue Ann was diagnosed with breast cancer 7 years ago following
her yearly mammogram.
The HHS secretary acknowledged critics’ arguments that the screening
procedure is not perfect and that false positives do cause anxiety in women.
"But mammography is an important and effective early detection tool
that does help to save lives. We want women to understand this point very
clearly," he said.
The USPSTF is an independent panel of nongovernment experts in prevention
and primary care that assesses scientific evidence and makes recommendations
across a broad spectrum of preventive services. It is funded by the Agency
for Healthcare Research and Quality (AHRQ), a part of HHS.
The panel’s new mammography recommendations follow a review of eight
randomized controlled trials, four of mammography alone and four of
mammography plus clinical breast examination. The reports include follow-up
results of 11 to 20 years, and all of them have been published since USPSTF
issued its last recommendations on the screening process.
"We acknowledge that the clinical trials are flawed and they are not
perfect . . . but the task force concluded that the studies are still valid
and that mammography screening reduces deaths from breast cancer," said
Janet Allen, PhD, RN, USPSTF vice chair. "We based our recommendations
on the overall quality of the studies or the evidence."