ACP and ACR issue consensus points for mammography screening

The American College of Physicians (ACP) and the American College of Radiology (ACR) recently released a joint set of talking points regarding how and when women should have screening mammograms. The points are the result of a meeting between the two organizations in May 2010 and follow-up discussions that took place through August 2011.

Historically, the screening guidelines for each organization have differed. Yet, when controversy arose after the U.S. Preventive Services Task Force (USPSTF) guidelines were released in November 2009, the groups decided to collaborate to find common ground and provide guidance for physicians and other medical personnel to help clarify the pros and cons of screening mammography to their patients.

For example, the ACP and the ACR have differing mammography screening guidelines for women ages 40 to 49. The ACP guideline recommended a shared decision-making approach for this group, stating that annual mammograms should be based on the benefits and harms of screening, the individual woman's preferences, and her breast cancer risk profile. The rationale behind the ACP recommendation is that the benefits of mammography do not clearly outweigh the potential harms for all women ages 40 to 49, and, because of the potential risks, women should be fully informed rather than routinely screened.

Conversely, the ACR recommends that asymptomatic women begin annual screening at age 40. The ACR rationale for this approach is that the overall benefits of mammography outweigh potential harms in women in this age group, and almost all women would be willing to accept the risks of screening for the mortality benefit.

Although each group maintains separate recommendations, a consensus was reached on important talking points that can be used by physicians, technologists, and others to educate themselves and others about the benefits and risks surrounding mammography screening. The talking points are available online.