NCI Recommends Mammography Screening for Women in 40s

BETHESDA, Md--Ending what began as a year's evaluation of scientificevidence and became an emotionally charged public debate, the NationalCancer Institute has recommended that women between ages 40 and 49 geta screening mammogram every one or two years.

Director Richard D. Klausner, MD, said that the NCI would implementthis and other recommendations made by the presidentially appointed NationalCancer Advisory Board (NCAB). In late February, the NCAB named a workinggroup to review the scientific evidence and make its recommendations forscreening mam-mography. The full board approved these, 17 to 1.

Epidemiologist Kay Dickersin, PhD, of the University of Maryland Schoolof Medicine, herself a breast cancer survivor, cast the lone dissentingvote. "She felt the evidence did not justify the recommendation forall women in their 40s," said NCAB chair Barbara K. Rimer, DrPH, ofDuke University.

The NCAB also urged that all third-party payers cover screening mammo-gramsper the recommendations. President Clinton has directed all federal healthplans to comply, beginning in 1998.

The President also said he would ask Congress to cover Medicare patientsfor annual screening mammography, and state Medicaid directors to coversuch screenings for their beneficiaries beginning at age 40. He pledgedthe federal government "will pay its matching share."

Dr. Klausner announced the new NCI recommendations days after the AmericanCancer Society (ACS) issued even stronger guidelines. The ACS, which hadpreviously suggested screening for women in their 40s every one or twoyears, now urges annual mammograms.