Who is the US Preventive Services Task Force?

The past 24 hours I have heard at least a dozen media pundits commenting on when breast cancer screening should or shouldn’t be done. Apparently most seem to think that disease and specialty societies trump the US PSTF. They have bashed “government bureaucrats” who are apparently trying “to deny women care.”

Let’s understand the nature of this Task Force – It is lead by the Agency for Healthcare Research and Quality (AHRQ). All members reviewing breast cancer screeening, save the two PhD nurses, are physician experts, from various specialty colleges, academia and public health service; the majority also have public health degrees in addition. “Federal partners include the Centers for Disease Control and Prevention (CDC), Department of Defense (DOD), Centers for Medicare and Medicaid Services (CMS), Department of Veterans Affairs (VA), Health Resources and Services Administration (HRSA), National Institutes of Health (NIH), U.S. Army Center for Health Promotion and Preventive Medicine, and the U.S. Food and Drug Administration (FDA). Primary care partners include the American Academy of Family Physicians, American Academy of Pediatrics, American Academy of Physician Assistants, American College of Obstetricians and Gynecologists, American College of Physicians, American College of Preventive Medicine, America's Health Insurance Plans, the Canadian Task Force on Preventive Health Care, the National Committee for Quality Assurance, and the Pan American Health Organization.” [1]

“The USPSTF conducts rigorous, impartial assessments of the scientific evidence for the effectiveness of a broad range of clinical preventive services, including screening, counseling, and preventive medications. Its recommendations are considered the "gold standard" for clinical preventive services. [Here are the methods.] The mission of the USPSTF is to evaluate the benefits of individual services based on age, gender, and risk factors for disease; make recommendations about which preventive services should be incorporated routinely into primary medical care and for which populations; and identify a research agenda for clinical preventive care. Recommendations issued by the USPSTF are intended for use in the primary care setting… to present health care providers with…the evidence behind each recommendation, allowing clinicians to make informed decisions about implementation.” [2]

No other organization goes through such a rigorous examination of the evidence for clinical recommendations for the asymptomatic general population. These recommendations are obviously different than for a patient who is symptomatic, has a family history or would otherwise be considered high risk. It is also important to understand and weigh the capabilities, limitations, benefits and potential harms of a given screening test. The distinction not being made by the press is the difference between population medicine versus care of the individual patient.