The focus of this meeting was the issue of early detection of breast cancer in women from 40 to 49 (i.e., under the age of 50) and living in developed countries where health services are generally available to all with few exceptions.
There are different breast-screening recommendations in different countries. For example the "Europe Against Cancer" code of the European Community is different from the United States, where the National Cancer Institute and the American Cancer Society recommend mammography every 1 to 2 years, plus physical examinations and, of course, periodic breast self-examination.
Meetings have been organized this year by the American Cancer Society in February and the National Cancer Institute in April, and the UICC has followed these with interest. The present position of the ACS is that, on the basis of the data available, the guidelines should be maintained. The report to the President's Committee of the National Cancer Institute is not yet officially finalized.
This situation can cause confusion and concern. Those interested in women's issues, and the public in general, feel that the experts might be making distinctions that are too fine. While it is essential that progress be made in medicine, and most progress is made when experts disagree, this issue is too large for it to remain only the concern of experts.
With 1 in 9 women in the USA now likely to be affected by breast cancer, what is required is a general health policy that will provide maximum support for early-detection programmes. For example, the February meeting of the ACS heard one report from Sweden that suggested that, contrary to much current debate, women under 50 should in future be screened every year.
Obviously these matters are not yet settled. The UICC convened a body of experts, not only to look at current policy, but also to consider the future. We are, moreover, concerned with quality control and with the availability of resources, elements which should not be overlooked in such deliberations.
WORKGROUP 1