USPSTF
Menstuff® has information on
the United States Preventive Services Task Force.
Direct short-cut to this page:
http:/bit.ly/ocDm3v
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families are to believe the out-of-date evidence presented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 doesnt 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): 11722. 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): 1237. PMID
17576997.
6. "Screening for breast cancer: U.S.
Preventive Services Task Force recommendation statement".
Ann. Intern. Med. 151 (10): 71626, W236.
November 2009. doi:10.1059/0003-4819-151-10-202311170-00008.
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, 1975-2023, 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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