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December 17, 1997

Preserving Scientific Debate and Patient ChoiceLessons From the Consensus Panel on Mammography Screening

Author Affiliations

From the Department of Family Practice, Medical College of Virginia of Virginia Commonwealth University, Fairfax (Dr Woolf), and Department of Health Policy and Management, Johns Hopkins School of Hygiene and Public Health, Baltimore, Md (Dr Lawrence).

JAMA. 1997;278(23):2105-2108. doi:10.1001/jama.1997.03550230081042

The National Institutes of Health (NIH) convened a consensus conference in January 1997 to examine new evidence on the effectiveness of mammographic screening for breast cancer in women ages 40 to 49 years. After reviewing the data and hearing testimony from experts and advocates, the panel concluded that the evidence did not support a universal recommendation for or against routine mammography in this age group.1 The panel advised each woman to decide with her physician, based on her personal values and risk factors, whether to have the test. Critics denounced this recommendation, accusing the panel of distorting the evidence and misleading the public.2 News accounts emphasized the acrimony among health professionals and medical groups.3 The US Senate passed a resolution repudiating the panel, demanded revised guidelines, and convened investigative hearings.4,5 Finally, in March the American Cancer Society and National Cancer Institute (NCI) recommended that all women