Cancer Screening Guideline Challenges: Methods, Communication, and Application

The United States Preventive Services Task Force received substantial attention when it released a new recommendation in November 2009. Over the last 20 years, as experience increased with screening for breast, cervical, colon, and prostate cancer, there has been growing controversy about it benefits and concern about its adverse outcomes including false positive tests and over-diagnosis. Simultaneously there is a growing popular faith in early detection. The USPSTF experience in the fall of 2009 was born out of these conflicting trends and raised questions about methodological approaches to screening guideline development, the role of communication, and the challenge public health practitioners face in practice when guidelines appear to differ. This session will discuss considerations in cancer screening guideline development, communication, and application. The overall goal of the session is to contribute to improvement in the development and application of cancer screening guidelines. The guideline development method of the USPSTF will be reviewed, and questions about new methods and approaches will be highlighted to provide greater insight and data for guideline developers. Key issues such as the use of simulation modeling, the number needed to screen versus the number needed to invite to screening to save one life, and the calculation of “net benefit” will be addressed. Research paths for better understanding in how to communicate effectively about cancer screening guideline development and implementation will be presented. Trends in lay understanding of screening recommendations, and considerations in communicating guideline changes to lay audiences and the media will be highlighted. Responsibilities and challenges of public health departments who need to interpret the science, the recommendations, and the reality of disparate use of cancer screening services across the US population they serve will be presented. Further, how this role may change as health care reform becomes reality will be discussed.

Abstracts and Speakers: Methods and methodology guideline development by Chair, USPSTF (20 minutes) Communicating cancer guidelines by Chief,Health Communication and Informatics Research, Branch Behavioral Research Program,DCCPS, NCI. (20 minutes) Applying cancer guidelines in practice by Director and Health Officer, LA County Department of Public Health and Professor at the UCLA school of Public Health and Medicine. (20 minutes)

Discussion: (30 min) This session will be moderated by Senior Scientist and the Acting Chief for the Applied Cancer Screening Research Branch at NCI's Division of Cancer Control and Population Sciences.