Feature

Is the United States Preventive Services Task Force still a voice of caution?

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j743 (Published 21 February 2017) Cite this as: BMJ 2017;356:j743

This article has a correction. Please see:

  1. Jeanne Lenzer, associate editor
  1. The BMJ
  1. jlenzer{at}bmj.com

Recent recommendations issued by the USPSTF have surprised some experts who say they may lead to overtesting and overtreatment. Jeanne Lenzerinvestigates

Independent analyses of medical research are prized by doctors concerned about industry bias. Created in 1984, the United States Preventive Services Task Force (USPSTF) has earned a reputation for its independent, objective guidance on clinical preventive services, and many have long viewed its recommendations as a bulwark against the increasing excesses of these services.

However in 2009, the task force was the subject of a backlash after issuing an unenthusiastic “grade C” recommendation regarding routine mammography screening of women aged 40 to 49. In 2012, USPSTF found itself again in the hot seat following its “grade D” recommendation against routine prostate cancer screening. Grade D recommendations are issued when the task force finds “moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.”

Following these conservative recommendations, industry funded lobbying efforts resulted in Congress seeking to terminate the task force by cutting off funding to the Agency for Healthcare Research and Quality (AHRQ), the government agency that convenes the task force. Several bills attempted to “zero out” AHRQ’s funding.12 In December 2015, Congress sent a warning shot to the agency and cut 8% of its budget.1

It is unclear what effects these threats have had. But in the past few years, the task force has issued several recommendations that are far more liberal in promoting interventions, which some experts say will lead to overtesting and overtreatment.345678

In 2013, USPSTF recommended screening high risk smokers with low dose computed tomography screening.9 In January and February 2016 it recommended routine depression screening for all adults and all teens,1011 and …

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