A Guide to a Guidance Statement on Screening Guidelines
Cet article présente les recommandations de l'"American College of Physicians" concernant le dépistage du cancer du sein chez les femmes présentant un risque moyen de développer la maladie
In this issue, the American College of Physicians (ACP) Clinical Guidelines Committee presents its assessment of the quality and content of 7 English-language guidelines for breast cancer screening (1). The results of the assessment are 4 guidance statements that provide clarity and simplicity amidst the chaos of diverging guidelines. ACP guidance statements represent convergence across differing recommendations while highlighting important points for physicians to consider in shared decision-making conversations with their patients about routine breast cancer screening.
Variability in the interpretation of medical data has long been studied (2) and is a known phenomenon in breast cancer screening, both in radiologists' subjective interpretation of mammograms (3) and in objective interpretation of data from randomized clinical trials. Indeed, there is also marked variability in the makeup of screening guideline bodies, and research has shown conflict-of-interest issues related to authors' clinical specialties in earlier mammography guidelines (4). Of note, even among the members of the ACP Clinical Guidelines Committee, assessment and quality ratings varied considerably. These ACP guidance statements were developed after review of guidelines familiar to most screening stakeholders, including guidance from the U.S. Preventive Services Task Force, American Cancer Society, American College of Radiology, American College of Obstetricians and Gynecologists, Canadian Task Force on Preventive Health Care, National Comprehensive Cancer Network, and the World Health Organization.
Annals of Internal Medicine , éditorial en libre accès, 2018