The United States Preventive Services Task Force (USPSTF) has posted and is seeking public input on a Draft Research Plan (DRP) for breast cancer screening, previewing its plan for revisiting its recommendations on this topic. Comments on the plan are accepted through Feb. 17, 2021.
The draft plan outlines the proposed analytical framework, key questions and contextual questions to be considered, and describes the planned research approach (study characteristics and criteria that will be used to identify studies that will be considered). The American College of Radiology® (ACR®) Breast Imaging Government Relations Committee, Breast Imaging Commission and the Screening Leaders Group are reviewing the DRP and will help inform ACR comments.
Among the key questions the task force proposes to review:
What is the comparative effectiveness of different breast cancer screening strategies (e.g. by modality, interval, initiation age, use of supplemental imaging or personalization based on risk factors) on breast cancer morbidity and breast cancer–specific or all-cause mortality? Does comparative effectiveness differ by population (e.g., by age, breast density, race/ethnicity or family history)?
What is the comparative effectiveness of different breast cancer screening strategies (e.g. by modality, interval, initiation age, use of supplemental imaging or personalization based on risk factors) on the incidence of advanced breast cancer? Does comparative effectiveness differ by population (e.g., by age, breast density, race/ethnicity or family history)?
What are the comparative harms of different breast cancer screening strategies (e.g. by modality, interval, initiation age, use of supplemental imaging or personalization based on risk factors)? Do the comparative harms vary by population (e.g. by age, breast density, race/ethnicity or family history)?
Radiology’s input on the draft research plan is critical because the plan sets the foundation for what will be considered during USPSTF’s review of the topic. Since 2009, USPSTF’s recommendations on breast cancer screening have diverged from those of leading breast cancer experts. Legislation to recognize 2002 USPSTF guidelines for coverage decisions has helped ensure insurance coverage for screening mammograms for women beginning at age 40. USPSTF’s 2002 guidelines call for screening every one to two years starting at age 40 — rather than delayed and less frequent screening allowed under 2009/2016 USPSTF recommendations.