The history

In the US, there had been little debate over the recommendation made in 1977 by the National Cancer Institute (NCI) that women aged over fifty should have regular mammograms. However, over the years, younger women had received conflicting advice from various institutions, associations and organizations. Following an international workshop in 1993 to consider the most recent evidence, the NCI replaced its recommendation for regular screening with the advice that women aged between forty and forty-nine should talk to their doctor before deciding about screening. Most other organizations who had previously issued guidelines on screening disagreed with this and were in favour of women in the younger age group having regular screening as a matter of course. In January 1997, following the publication of results of the most recent trial, the NCI convened a consensus meeting to review the evidence. The unanimous conclusion of the independent panel that they set up was that there was insufficient evidence to recommend routine mammography, and that younger women should decide for themselves, in consultation with a health professional, whether or not they should be screened.

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