House blasts NCI mammography policy

Pressure is mounting on theNational Cancer Institute to retract its controversial guidelineson mammography screening of women in their 40s. The House of RepresentativesCommittee on Government Operations last month issued a seethingreport criticizing the NCI's policy change (SCAN 10/26/94). Thereport charges that flawed, biased decision-making by NCI officialsled to the institute's elimination of its mammography screeningrecommendations for women aged 40 to 49.

Controversy has raged since last December when the agency brokeconsensus with 12 medical and cancer organizations, eliminatingguidelines that promoted biennial screening for younger women(SCAN 12/15/93). The change stemmed from the NCI's InternationalWorkshop, where a panel reviewed data from eight randomized clinicaltrials and assessed the effectiveness of breast cancer screeningin various age groups. It concluded that younger women did notshow a statistically significant decrease in mortality after 10to 12 years' follow-up.

The House committee report, entitled "Misused Science: TheNational Cancer Institute's Elimination of Mammography Guidelinesfor Women in their Forties," faulted the agency for appointingworkshop leaders who were known critics of mammography screeningof younger women. The report also criticized the NCI for excludingmedical, scientific and public health groups, whose consensusformed the backbone of the NCI's prior policy. By not includingpositive data on the screening of younger women, the report asserts,the NCI "failed to uphold standards and scientific integrity.The result tarnished the scientific integrity of NCI and wastedmany taxpayer dollars.

In conclusion, the committee urged the NCI to revise its mammographyscreening statement to provide a more balanced view of the scientificevidence, and to hold a new consensus conference on the issue.