NCI Statement on Mammography Screening
A recent report in the scientific literature has reawakened debate about the value of screening mammograms. The analysis, which appeared in The Lancet* on October 20, 2001, reviewed the large, long-term mammography trials upon which the National Cancer Institute (NCI) and other groups have based their recommendations and guidelines concerning mammography screening. This review cited a number of possible flaws in the conduct of the trials and the methods used to analyze the data. The NCI has carefully considered the issues raised in The Lancet review. It has also considered the recent deliberations of the PDQ Screening and Prevention Editorial Board and of the U.S. Preventive Services Task Force and has consulted with a variety of experts in the field in order to determine whether a change in its position is warranted. After due consideration, NCI continues to recommend that:
Women in their 40s should be screened every one to two years with mammography.Women aged 50 and older should be screened every one to two years.Women who are at higher than average risk of breast cancer should seek expert medical advice about whether they should begin screening before age 40 and the frequency of screening. At the same time, NCI is determined to continue to address the uncertainties in the analysis of complex information surrounding screening mammograms. One of its highest priorities will be the monitoring and evaluation of new data on mammography from numerous studies now underway which will supplement the data from clinical trials. Most important, NCI is strongly committed to further research on early detection of breast cancer. "It is absolutely essential to look beyond the debate over the limitations of current data and to accelerate the development of better screening tools," said NCI director Andrew von Eschenbach, M.D. "While we will continue to be vigilant in reviewing data on mammography, we must emphasize research to develop more effective screening tools and strategies that hold promise for improved detection of breast cancer and, ultimately, for saving lives." ________________________* Olsen, O. and Gotzsche, P. (2001). Cochrane review on screening for breast cancer with mammography. The Lancet, 358, 1340-1342.
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