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IV

103D CONGRESS

2D SESSION H. CON. RES. 220

Expressing the sense of the Congress on the need for accurate guidelines

for breast cancer screening for women ages 40–49.

IN THE HOUSE OF REPRESENTATIVES

MARCH 9, 1994

Ms. SNOWE (for herself and Mr. SCHIFF) submitted the following concurrent

resolution; which was referred to the Committee on Energy and Commerce

CONCURRENT RESOLUTION

Expressing the sense of the Congress on the need for accurate guidelines for breast cancer screening for women

ages 40–49.

Whereas the National Cancer Institute is the lead Federal

agency for research on the causes, prevention, diagnosis

and treatment of cancer;

Whereas health professionals and consumers throughout the

Nation regard their guidelines as reliable scientific and

medical advice;

Whereas it has been proven that intervention with routine

screening for breast cancer with mammography can save

women’s lives at a time when we are unable to prevent

this disease;
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•HCON 220 IH

Whereas there are limitations to evaluating the efficacy of

mammography in a 5–10 year age range of women in existing studies designed to test mortality reduction from

breast cancer in a 25–30 year age range;

Whereas there were numerous shortcomings in a Canadian

study designed to address mortality reduction from

breast cancer in the 40–49 age range;

Whereas to date, it is not possible to have the same degree

of scientific confidence about the benefit of mammography for women ages 40–49 as exists for women ages

50–69 due to inherent limitations in the studies that

have been conducted;

Whereas meta-analysis (combining the results of several studies) is sometimes useful, the studies used to reach the

National Cancer Institute’s conclusions were not easily

combined because of variations in design, technology,

screening interval, the inclusion or exclusion of clinical

breast examination and quality;

Whereas the existing clinical trial data are inadequate to provide a definite answer to the efficacy of early detection

in the 40–49 age group and there has been a dramatic

change in technology during the 30-year period since the

initiation of the first study of breast cancer screening;

Whereas approximately 80 percent of women who are diagnosed with breast cancer have ‘‘no’’ identifiable risk for

this disease;

Whereas breast cancer is the leading cause of cancer death

among women in the age group 15–54;

Whereas the American Cancer Society and 21 other national

medical organizations, health and consumer groups are at

variance with the recently rescinded guideline of the Na-
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tional Cancer Institute for mammography for women

ages 40–49; and

Whereas the statement on breast cancer screening issued by

the National Cancer Institute on December 3, 1993, will

cause widespread confusion and concern among women

and physicians, erode confidence in mammography and

reinforce barriers and negative attitudes that keep women

of all ages from being screened: Now, therefore, be it

1 Resolved by the House of Representatives (the Senate

2 concurring), That it is the sense of the Congress that—

3 (1) adequately designed and conducted studies

4 are needed to determine the benefit of screening

5 women ages 40–49 through mammography and

6 other emerging technologies;

7 (2) the National Cancer Institute’s guidelines

8 on breast cancer screening should clearly state that

9 the uncertainty of evidence for women in this age

10 group is due to the limitations of existing studies;

11 and

12 (3) the National Cancer Institute should re13 scind its recent statement for mammography screen14 ing of women ages 40–49, and continue to issue

15 guidelines when clear evidence warrants a change.

Æ