U.S. Preventive Services Task Force

The United States Preventive Services Task Force (USPSTF) is "an independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services." The task force, a panel of primary care physicians and epidemiologists, is funded, staffed, and appointed by the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality.

The USPSTF does not consider cost-effectiveness. Recommendations are based solely upon evidence of medical benefit to the patient, no matter how expensive it is.

The USPSTF evaluates scientific evidence to determine whether medical screenings, counseling, and preventive medications work for adults and children who have no symptoms.

The methods of evidence synthesis used by the Task Force have been described in detail. In 2007, their methods were revised.

The USPSTF explicitly does not consider cost as a factor in its recommendations, and it does not perform cost-effectiveness analyses. American health insurance groups are required to cover, at no charge to the patient, any service that the USPSTF recommends, regardless of how much it costs or how small the benefit is.

The task force assigns the letter grades A, B, C, D, or I to each of its recommendations, and includes "suggestions for practice" for each grade. The Task Force also defined levels of certainty regarding net benefit.

Levels of certainty vary from high to low according to the evidence.

The USPSTF has evaluated many interventions for prevention and found several have an expected net benefit in the general population.

In 2009, the USPSTF updated its advice for screening mammograms. Screening mammograms, or routine mammograms, are X-rays given to apparently healthy women with no symptoms or evidence of breast cancer in the hope of detecting the disease in an early, easily treatable stage. The advice about using mammography in the presence of symptoms (such as a lump in the breast) is unchanged.

The previous advice was for all women over the age of 40 to receive a mammogram every one to two years. The new advice is more detailed. For women between the ages of 50 and 74, they have recommended routine mammograms once every two years in the absence of symptoms. Most American women who are diagnosed with breast cancer are diagnosed after age 60.

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