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 Duke University.
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.