USPSTF

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Who are these people?
Take Action to Save Early Detection of Prostate Cancer

 

Take Action to Save Early Detection of Prostate Cancer


ZERO is asking prostate cancer patients, survivors and advocates to take action to save early detection of prostate cancer! The United States Preventive Services Task Force, an independent panel appointed by the federal Department of Health and Human Services, has moved to ELIMINATE PROSTATE CANCER TESTING FOR ALL MEN.

The USPSTF is accepting public comments on the new recommendations for a limited time and we need you to ACT NOW and VOICE YOUR OPINION!

The new USPSTF guidelines rate PSA testing for all men “D,” meaning there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits. The decision of no confidence on the PSA test by the U.S. Government condemns men to die if families are to believe the out-of-date evidence presented by the USPSTF.

A decision on how best to test and treat for prostate cancer must be made between a man and his doctor, not a panel that doesn’t include a urologist or medical oncologist. Read more about ZERO's position on PSA testing here and TAKE ACTION by commenting on the recommendations and writing to your elected officials and the media using the links below!

The U.S. Preventive Services Task Force (USPSTF) welcomes you to the comments page for the draft Recommendation Statement on Screening for Prostate Cancer. The USPSTF is seeking comments to help make this draft Recommendation Statement more useful to primary care providers and others who are interested. You do not have to answer each question. Answer only those that interest you. All comments will be fully considered. www.uspreventiveservicestaskforce.org/uspstf_form3

Who are these people?


The U.S. Preventive Services Task Force (USPSTF) is "an independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services."[1] The task force, a panel of primary care physicians and epidemiologists, is funded, staffed, and appointed by the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality.[2]

Methods
The methods of evidence synthesis used by the Task Force have been described in detail.[3] In 2007, their methods were revised.[4][5]

Mammography recommendationsIn 2009, the USPSTF updated its advice for screening mammograms.[6] Screening mammograms, or routine mammograms, are X-rays given to apparently healthy women with no symptoms or evidence of breast cancer in the hope of detecting the disease in an early, easily treatable stage. The advice about using mammography in the presence of symptoms (such as a palpable lump in the breast) is unchanged.

The previous advice was for all women over the age of 40 to receive a mammogram every one to two years.[7] The new advice is more detailed.

For women between the ages of 50 and 74, they have recommended routine mammograms once every two years in the absence of symptoms. Most American women who are diagnosed with breast cancer are diagnosed after age 60.[8]

No recommendation is made about mammograms in women over the age of 75, as very little research has been performed in this age group.

The Task Force recommended against routine mammography to screen asymptomatic women aged 40 to 49 years for breast cancer. Patients in this age group should be educated about the risks and benefits of screening, and the decision whether to screen or not should be based on the individual situation and preferences.[9] The old advice was based on "weak" evidence for this age group.[7] The new advice is based on improved scientific evidence about the benefits and harms associated with mammography and is consistent with recommendations by the World Health Organization and other major medical bodies. Their recommendation against routine, suspicion-less mammograms for younger women does not change the advice for screening women at above-average risk for developing breast cancer or for testing women who have a suspicious lump or any other symptoms that might be related to breast cancer.

The change in the recommendation for younger women has been criticized by some physicians and cancer advocacy groups, such as Otis Brawley, the chief medical officer for the American Cancer Society,[10] and praised by physicians and medical organizations that support individualized and evidence-based medicine, such as Donna Sweet, the former chair of the American College of Physicians, who currently serves on its Clinical Efficacy Assessment Subcommittee.[11]

The USPSTF recommendation, which focuses solely on clinical effectiveness without regard to cost,[12] formally reduces the grade given for evidence quality from "B" to "C" (limited evidence prevents a one-size-fits-all recommendation) for routine mammograms in women under the age of 50.[13] With a grade C recommendation, physicians are required to consider additional factors, such as the individual woman's personal risk of breast cancer. Pending health care legislation would require insurance companies to cover any and all preventive services that receive an "A" or "B" grade, but permit them to use discretion on preventive services that receive a worse grade.[13]

The Vitter amendment to pending legislation in the U.S. Senate instructs insurers to disregard the task force's recommendation against frequent routine mammograms in asymptomatic younger women, and requires them to provide free annual mammograms, even for low-risk women, based on the outdated 2002 report.[13] This proposal is not yet law and may change. The efforts by politicians to reject the committee's scientific findings have been condemned as an example of unwarranted political interference in scientific research.[12]

History

From 1984 to 1989, the task force's stated purpose was to "develop recommendations for primary care clinicians on the appropriate content of periodic health examinations."[14]

References

1. Agency for Healthcare Research Quality www.ahrq.gov/clinic/uspstfix.htm

2. "U.S. Preventive Services Task Force: About USPSTF". www.ahrq.gov/clinic/uspstfab.htm Retrieved November 2009.

3. "U.S. Preventive Services Task Force: Methods and Background". www.ahrq.gov/clinic/uspstmeth.htm Retrieved 2007-08-23.

4. Guirguis-Blake J, Calonge N, Miller T, Siu A, Teutsch S, Whitlock E (2007). "Current processes of the U.S. Preventive Services Task Force: refining evidence-based recommendation development". Ann. Intern. Med. 147 (2): 117–22. PMID 17576998.

5. Barton MB, Miller T, Wolff T, et al. (2007). "How to read the new recommendation statement: methods update from the U.S. Preventive Services Task Force". Ann. Intern. Med. 147 (2): 123–7. PMID 17576997.

6. "Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement". Ann. Intern. Med. 151 (10): 716–26, W–236. November 2009. doi:10.1059/0003-4819-151-10-201711170-00008. PMID 19920272. www.annals.org/content/151/10/716.full

7. a b Screening for Breast Cancer: Recommendations and Rationale 2002

8. Cancer of the breast, SEER Stat Fact Sheets, summarizing Horner MJ, Ries LAG, Krapcho M, et al. (eds). SEER Cancer Statistics Review, 1975-2017, National Cancer Institute. Bethesda, MD, based on November 2008 SEER data submission, posted to the SEER web site, 2009.

9. www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm

10. "Task force opposes routine mammograms for women age 40-49" - Danielle Dellorto, CNN Medical Producer - www.cnn.com/2009/HEALTH/11/16/mammography.recommendation.changes/index.html

11. "Role of evidence based medicine in clinical decision-making addressed by ACP in testimony". American College of Physicians. 2 December 2009. www.acponline.org/pressroom/sweet_testimony.htm?hp

12. a b Stubbs, Joseph W. (24 November 2009). "Statement On the Politicization of Evidence-based Clinical Research". American College of Physicians. www.acponline.org/pressroom/pol_ebcr.htm

13. a b c Walker, Emily (3 December 2009). "Senate Affirms Screening Mammography for 40-Year-Olds". ABC News. abcnews.go.com/Health/OnCallPlusBreastCancerNews/senate-affirms-screening-mammography-40-year-olds/story?id=9243563 Retrieved 3 December 2009.

14.Office of Disease Prevention and Health Promotion odphp.osophs.dhhs.gov/pubs/guidecps/uspstf.htm

External links

USPSTF on AHRQ website
USPSTF website

Source: en.wikipedia.org/wiki/United_States_Preventive_Services_Task_Force

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