The New Proposed U.S. Preventive Services Task Force Recommendation on Breast Cancer Screening for Women in Their 40s: Should the Message Change?
Authors: Russell P. Harris
Journal: Annals of Internal Medicine (2024)

Ideas and Opinions6 February 2024The New Proposed U.S. Preventive Services Task Force Recommendation on Breast Cancer Screening for Women in Their 40s: Should the Message Change?Russell P. Harris, MD, MPHRussell P. Harris, MD, MPHCecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina (R.P.H.).Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-2908 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In May 2023, the U.S. Preventive Services Task Force (USPSTF) posted a new draft recommendation for breast cancer screening, recommending mammography screening for women aged 40 to 74 years (B recommendation) (1). This is the latest in a series of USPSTF recommendations on this topic, dating back to 1989. Although the recommendation for screening women aged 50 to 74 years has remained relatively constant over these years, the recommendation for women aged 40 to 49 years has been confusing to many. This latest recommendation may contribute to that confusion. Because I participated as both an evidence reviewer (for 20 years) ...References1. U.S. Preventive Services Task Force. Draft Recommendation Statement: Breast Cancer: Screening. 9 May 2023. Accessed at www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/breast-cancer-screening-adults on 20 May 2023. Google Scholar2. U.S. Preventive Services Task Force. Guide to Clinical Preventive Services: Report of the U.S. Preventive Services Task Force. Williams & Wilkins; 1989. Google Scholar3. U.S. Preventive Services Task Force. Guide to Clinical Preventive Services: Report of the U.S. Preventive Services Task Force. 2nd ed. Williams & Wilkins; 1996. Google Scholar4. Humphrey LL, Helfand M, Chan BKS, et al. Breast cancer screening: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2002;137:347-360. [PMID: 12204020] doi:10.7326/0003-4819-137-5_part_1-200209030-00012 LinkGoogle Scholar5. Nelson HD, Tyne K, Naik A, et al; U.S. Preventive Services Task Force. Screening for breast cancer: an update for the U.S. Preventive Services Task Force. Ann Intern Med. 2009;151:727-737. [PMID: 19920273] doi:10.7326/0003-4819-151-10-200911170-00009 LinkGoogle Scholar6. U.S. Preventive Services Task Force. Screening for breast cancer: recommendations and rationale. Ann Intern Med. 2002;137:344-346. [PMID: 12204019] doi:10.7326/0003-4819-137-5_part_1-200209030-00011 LinkGoogle Scholar7. U.S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;151:716-726. [PMID: 19920272] doi:10.7326/0003-4819-151-10-200911170-00008 LinkGoogle Scholar8. Siu AL; U.S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2016;164:279-296. [PMID: 26757170] doi:10.7326/M15-2886 LinkGoogle Scholar9. Henderson JT, Webber EM, Weyrich M, et al. Screening for Breast Cancer: A Comparative Effectiveness Review for the U.S. Preventive Services Task Force. Accessed at www.uspreventiveservicestaskforce.org/uspstf/document/draft-evidence-review/breast-cancer-screening-adults on 20 May 2023. Google Scholar10. Woloshin S, Jørgensen KJ, Hwang S, et al. The new USPSTF mammography recommendations — a dissenting view. N Engl J Med. 2023;389:1061-1064. [PMID: 37721382] doi:10.1056/NEJMp2307229 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Russell P. Harris, MD, MPHAffiliations: Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina (R.P.H.).Note: Dr. Harris was a member of the RTI International–University of North Carolina Evidence-based Practice Center doing systematic reviews for the USPSTF from 1997 to 2018. He was also a member of the USPSTF from 2003 to 2008. He was present at the USPSTF meetings in which the 2002 and 2009 breast cancer screening recommendations were discussed and finalized.Acknowledgment: The author thanks Steven H. Woolf, MD, MPH, and Linda S. Kinsinger, MD, MPH, for helpful comments on earlier drafts of this article.Disclosures: The author has reported no disclosures of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-2908.Corresponding Author: Russell P. Harris, MD, MPH, 18 Herron View Lane, Weaverville, NC 28787; e-mail, rharris@med.unc.edu.Author Contributions: Conception and design: R.P. Harris.Analysis and interpretation of the data: R.P. Harris.Drafting of the article: R.P. Harris.Critical revision for important intellectual content: R.P. Harris.Final approval of the article: R.P. Harris.Statistical expertise: R.P. Harris.Administrative, technical, or logistic support: R.P. Harris.Collection and assembly of data: R.P. Harris.This article was published at Annals.org on 6 February 2024. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Latest Keywords Biopsy Breast cancer Breast cancer screening Cancer screening Health services research Mammography Overdiagnosis Randomized trials Systematic reviews ePublished: 6 February 2024 Copyright & PermissionsCopyright © 2024 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...