Most states' breast cancer screening plans do not comply with USPSTF guidelines

Many comprehensive cancer control (CCC) state plans do not align with that of the U.S. Preventive Services Task Force (USPSTF) when it comes to breast cancer screening guidelines. 

The discrepancies are based on when exactly women should begin and end breast cancer screening when they are at average risk. 

“All of the organizations with recommendations agree on the benefits of breast cancer screening for women at average risk,” corresponding author Norma F. Kanarek, PhD, MPH, of the Department of Environmental Health and Engineering at Johns Hopkins University Bloomberg School of Public Health in Baltimore, and co-authors write. “However, the ages at which women should start and end mammography examinations and the frequency of mammography examinations have been a matter of political, emotional, and scientific debate for 3 decades.” 

These particular guidelines have undergone multiple changes over the years, and depending on the organization, the recommendations do vary. Further complicating the matter is insurance and government coverage mandates that require insurers to pay for breast cancer screenings based on risk and age. Additionally, the Centers for Disease Control and Prevention requires compliance from states in order to receive funding for comprehensive cancer control planning.

Experts recently compared these state CCC plan objectives to that of the USPSTF to evaluate for consistency and found that most states’ plans do not align with the most recent (2016) guidelines for screening. Of the 51 plans, just 31% were consistent with the USPSTF recommendations pertaining to the age and frequency of screening women at average risk. Almost half of states were at least partially consistent, and 9 plans did not comply with any of the recommended guidelines. 

“This variation is partially due to differences in state-specific planning considerations and discretion, variations in recommendations among national organizations, and publication of plans prior to the most current USPSTF recommendation (2016),” the authors noted. “Specifying the concept that high-risk populations need different age and frequency of screening recommendations than the general population may reduce heterogeneity among plans.” 

The authors went on to suggest that this could improve by issuing single, consistent messages pertaining to the general population and “explicitly” distinguishing women at average risk from those with higher risks. 

The full study can be viewed at JAMA Network Open

More on breast cancer screening: 

Experts suggest new follow-up imaging protocols for vaccine-related lymphadenopathy

AI-based mammo screening protocol reduces radiologist workload by 62%

'Surprising' decline in annual screening among breast cancer survivors has experts concerned

The impact of state-level digital breast tomosynthesis coverage mandates

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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.

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