Monday, 16 November 2009

Breast Cancer Screening Guidelines Changing again

Furore in the colleges and societies, as the US preventive services task force releases it's new breast cancer screening guidelines, following the release of a paper in the Annals of Internal Medicine today

Their recommendations for starting screening at 50 (for women without a family history of breast cancer) with mammograms every 2 years, and ending at 74 years, more closely mimics the recommendations for screening in European countries, and broadly similar to the UK NHSBSP.

The task force is an independent panel of experts in prevention and primary care appointed by the federal Department of Health and Human Services.

The guidelines were published in today's (Nov 16, 2009) edition of the Annals of Internal Medicine

In order to formulate its guidelines, the task force used new data from mammography studies in England and Sweden and also commissioned six groups to make statistical models to analyze the aggregate data. The models were the only way to answer questions like how much extra benefit do women get if they are screened every year

Dr. Karla Kerlikowske, a professor in the department of medicine, epidemiology and biostatistics at the University of California, San Francisco said "The message for most women is to forgo routine mammograms if they are in their 40s.

Starting at age 50, Dr. Kerlikowske said, “the message is to get 10 mammograms in a lifetime, one every two years.” That way they get the most benefit and the least harm from the test. If women are healthy, she added, they might consider having mammograms every two years until age 74.

Nearly two-thirds of all women in their 40s had mammograms within the last two years, as did 72 percent of women age 50 to 65, according to an editorial by Dr. Kerlikowske that accompanies the report.

The Society of Breast Imaging and the American College of Radiology, the American Cancer Society, and many other respected professional organizations, have voiced strong opposition to the changes proposed in the articles.

It is the opinion of the SBI leadership that adopting these guidelines would result in a major step backward in women's healthcare and increased deaths from breast cancer.

Immediately, they provided a number of guidance documents and statements as follows (which is a model for speedy response to crises) -

USPSTF Mammography Recommendations Will Result in Unnecessary Breast Cancer Deaths Each Year

Talking Points in response to USPSTF Statement

Detailed ACR Statement on Ill Advised and Dangerous USPSTF Mammography Recommendations
: Mammography Screening References

American Cancer Society Statement

Komen Screening Statement 11-16-09

NCI Statement