BETHESDA, Md--Ending what began as a year's evaluation of scientific
evidence and became an emotionally charged public debate, the National
Cancer Institute has recommended that women between ages 40 and 49 get
a screening mammogram every one or two years.
Director Richard D. Klausner, MD, said that the NCI would implement
this and other recommendations made by the presidentially appointed National
Cancer Advisory Board (NCAB). In late February, the NCAB named a working
group to review the scientific evidence and make its recommendations for
screening mam-mography. The full board approved these, 17 to 1.
Epidemiologist Kay Dickersin, PhD, of the University of Maryland School
of Medicine, herself a breast cancer survivor, cast the lone dissenting
vote. "She felt the evidence did not justify the recommendation for
all women in their 40s," said NCAB chair Barbara K. Rimer, DrPH, of
The NCAB also urged that all third-party payers cover screening mammo-grams
per the recommendations. President Clinton has directed all federal health
plans to comply, beginning in 1998.
The President also said he would ask Congress to cover Medicare patients
for annual screening mammography, and state Medicaid directors to cover
such screenings for their beneficiaries beginning at age 40. He pledged
the federal government "will pay its matching share."
Dr. Klausner announced the new NCI recommendations days after the American
Cancer Society (ACS) issued even stronger guidelines. The ACS, which had
previously suggested screening for women in their 40s every one or two
years, now urges annual mammograms.