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The '''United States Preventive Services Task Force''' ('''USPSTF''') is "an independent panel of experts in primary care and prevention that systematically reviews the [[Evidence-based medicine|evidence of effectiveness]] and develops recommendations for clinical preventive services".<ref>{{cite web|url=https://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/index.html|website=Agency for Healthcare Research Quality|title=Clinical Guidelines and Recommendations}}</ref> The task force, a volunteer panel of primary care
==Intent==
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==Methods==
The methods of evidence synthesis used by the Task Force have been described in detail.<ref>{{cite web|title=Methods and Processes|website=US Preventive Services Task Force|url=http://www.uspreventiveservicestaskforce.org/Page/Name/methods-and-processes|
=== No weight given to cost-effectiveness ===
The USPSTF explicitly does not consider cost as a factor in its recommendations, and it does not perform cost-effectiveness analyses.<ref name=":Branvani">{{cite journal|title=An Economic Framework For Preventive Care Advice|url=http://content.healthaffairs.org/content/33/11/2034|journal=Health Affairs|date=2014-11-01|issn=0278-2715|pages=2034–2040|volume=33|issue=11|first1=Mark V.|last1=Pauly|first2=Frank A.|last2=Sloan|first3=Sean D.|last3=Sullivan|doi=10.1377/hlthaff.2013.0873|pmid=25368000|doi-access=
===Grade definitions===
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== Recommended prevention ==
The USPSTF has evaluated many interventions for prevention and found several have an expected net benefit in the general population.<ref>{{cite web|title = USPSTF A and B Recommendations by Date|url=http://www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-recommendations-by-date/|website=US Preventive Services Task Force|
* Aspirin in men 45 to 79 and women 55 to 79 for cardiovascular disease
* Colon cancer screening by colonoscopy, occult blood testing, or sigmoidoscopy in adults 45 to 75.<ref>{{Cite journal|url=https://jamanetwork.com/journals/jama/fullarticle/2779985|doi=10.1001/jama.2021.6238|title=Screening for Colorectal Cancer|year=2021|last1=Davidson|first1=Karina W.|last2=Barry|first2=Michael J.|last3=Mangione|first3=Carol M.|last4=Cabana|first4=Michael|last5=Caughey|first5=Aaron B.|last6=Davis|first6=Esa M.|last7=Donahue|first7=Katrina E.|last8=Doubeni|first8=Chyke A.|last9=Krist|first9=Alex H.|last10=Kubik|first10=Martha|last11=Li|first11=Li|last12=Ogedegbe|first12=Gbenga|last13=Owens|first13=Douglas K.|last14=Pbert|first14=Lori|last15=Silverstein|first15=Michael|last16=Stevermer|first16=James|last17=Tseng|first17=Chien-Wen|last18=Wong|first18=John B.|last19=Wong|first19=J. B.|journal=JAMA|volume=325|issue=19|pages=1965–1977|pmid=34003218|s2cid=234769050|doi-access=free}}</ref>
* Low-dose CT scans for adults 55 to 80 at increased risk of lung cancer
* Osteoporosis screening via bone [[dual-energy X-ray absorptiometry]] (DEXA) in women over 65
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==Breast cancer screening==
In 2009, the USPSTF updated its advice for screening [[mammogram]]s.<ref name=pmid19920272>{{cite journal
|title=Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement|journal=Ann. Intern. Med.|volume=151|issue=10|pages=716–26, W–236|date=November 2009|doi=10.7326/0003-4819-151-10-200911170-00008|pmid=19920272|author1=US Preventive Services Task Force|url=https://cdr.lib.unc.edu/downloads/4t64gs692}}</ref> 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 previous advice was for all women over the age of 40 to receive a mammogram every one to two years.<ref name=AHRQ2002>{{cite web|url=http://www.ahrq.gov/clinic/3rduspstf/breastCancer/brcanrr.htm|website=Agency for Healthcare Research Quality|title=Screening for Breast Cancer: Recommendations and Rationale|year=2002}}</ref>
The USPSTF declared that there is insufficient evidence to make any statement about the use of mammograms in women over the age of 75, as very little research has been performed in this age group.
The Task Force made no recommendation about 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.<ref>{{cite web|url=http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm|title=Final Update Summary: Breast Cancer: Screening|website=US Preventive Services Task Force}}</ref> The old advice was based on "weak" evidence for this age group.<ref name=AHRQ2002/> 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.
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]],<ref>{{cite web|url=http://www.cnn.com/2009/HEALTH/11/16/mammography.recommendation.changes/index.html|title=Task force opposes routine mammograms for women age 40-49|first=Danielle|last=Dellorto|website=CNN}}</ref> 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.<ref name=ACP>{{cite web|url=http://www.acponline.org/pressroom/sweet_testimony.htm?hp|title=Role of evidence based medicine in clinical decision-making addressed by ACP in testimony|website=American College of Physicians|date=2 December 2009}}</ref>
The USPSTF recommendation, which focuses solely on [[clinical effectiveness]] without regard to cost,<ref name=ACP2 /> formally reduces the [[Evidence-based medicine#Categories of recommendations|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.<ref name=Vitter-Mikulski>{{cite news
|title=Senate Affirms Screening Mammography for 40-Year-Olds|author=Walker, Emily|date= 3 December 2009|publisher=ABC News|
The Vitter amendment to the Mikulski 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.<ref name=Vitter-Mikulski/> This proposal is not yet law and may change. {{update inline|date=May 2018}} The efforts by politicians to reject the committee's scientific findings have been condemned as an example of unwarranted [[Politicization of science|political interference in scientific research]].<ref name=ACP2>{{cite web|title= Statement On the Politicization of Evidence-based Clinical Research|url= http://www.acponline.org/pressroom/pol_ebcr.htm|author= Stubbs, Joseph W.|website= American College of Physicians|date= 24 November 2009}}</ref>
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==Prostate cancer screening==
In the current recommendation published in
A final statement published in 2018 recommends basing the decision to screen on shared decision making in those 55 to 69 years old.<ref name=TF2017DraftPC/> It continues to recommend against screening in those 70 and older.<ref name=TF2017DraftPC>{{cite web|title=
==History==
==References==
{{
==External links==
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* [http://www.uspreventiveservicestaskforce.org USPSTF website]
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[[Category:Federal government of the United States|Preventive Services Task Force]]
[[Category:Task forces]]
[[Category:Agencies of the United States
[[Category:United States national commissions]]
[[Category:Health policy in the United States]]
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