Word: cancer
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Dates: during 2000-2009
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...USPSTF, a volunteer group of 16 health professionals, is often considered to issue the most conservative recommendations compared with other national groups. In 2002, for instance, it called for breast-cancer screening every one or two years for women ages 40 to 49, while other guidelines advocated yearly tests. For its updated 2009 recommendations, the USPSTF analyzed clinical trials on the benefits of mammography - much of that same research was also evaluated for the task force's 2002 decision - while folding in new data on the risks and harms of screening. Those risks include false positive results, over-diagnosis, patient...
Overall, based on a review of mammography trials, the panel found that having a yearly mammogram screening cuts the risk of breast-cancer death 15% in women ages 40 to 49. That reduction, it should be noted, is relative, not absolute. The absolute risk of breast-cancer death after age 40 is 3% without annual screening, according to the computer models. That means that with routine screening, which leads to a 15% lower risk of death from breast cancer, a woman's absolute risk drops to 2.6%. Small numbers in either case. Put another way, the panel concluded, the benefit...
That benefit increases, however, with the age of the women being screened, as the risk of breast cancer rises: among women 50 to 59, one death is averted for every 1,339 women routinely screened; among women 60 to 69, 377 mammograms would be needed to prevent one death. The task force's computer models further showed that shifting women's screening schedule from yearly to once every two years retains 81% of the benefit of screening while reducing the harms like false positives by half...
Such details were bound to get lost in a heated - and highly politicized - discussion of a topic that is for most women more emotional than medical. Add to that an immediate offensive blitz by some cancer doctors who were concerned that the new guidelines would essentially limit their patients' options for preventing breast-cancer death. "I am appalled and horrified," says Dr. David Dershaw, director of breast imaging at Memorial Sloan-Kettering Cancer Center. "We have something that saves lives, and to say we are not going to do it anymore is unconscionable...
...panel stands by its new recommendations, relying on the data, which simply do not support the benefit of routine screening when balanced with risks, among younger women. The new recommendations are also backed by some prominent physicians, including the cancer surgeon Dr. Susan Love, who agree there's insufficient data to show that screening under 50 works. The debate, says Dr. Len Lichtenfeld of ACS, is not likely to end soon. "This is the beginning of a discussion that will likely continue vigorously over the next several months, if not years," he predicts...