Oral

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 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 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.

Session Objectives: 1. To identify 2 methodological issues in guideline development that could be explored and resolved through further research 2. To identify 2 specific steps guideline developers could consider to maximize the clarity of their communication to lay audiences, and one area of needed research 3. To identify 2 specific activities public health departments can undertake in the face of guideline controversies that will improve their ability to meet their responsibilities and one area where research is needed

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH)