DISPUTE CONTINUES OVER MAMMOGRAMS FOR WOMEN IN THEIR 40S.

Byline: Damaris Christenson Medical Tribune News Service

Another federal panel has failed to resolve the controversy over whether women in their 40s should get regular breast X-rays.

The National Cancer Advisory Board (NCAB), which helps set policy for the National Cancer Institute (NCI), said Tuesday that the NCI should issue clear guidance to women in their 40s who are considering whether to get a mammogram.

However, the advisory board did not issue any guidelines - and, indeed, said there might be no single recommendation.

Instead, they established a committee to craft a message that the NCI could give to women and health-care providers and determine the kind of products that could most effectively give women in their 40s the information they need to make an informed decision about the benefits and risks of mammograms.

The committee will report back to the advisory board before the board meets again in June.

Last month, an independent consensus panel of experts assembled by the National Institutes of Health said that scientific evidence did not justify recommending regular mammograms for healthy women under 50. They added that women in their 40s should make a decision about regular screening based on their personal evaluations of the risks and benefits of the procedure, and that insurers should pay for the tests if requested.

The controversial decision has caused a stir among the scientific and advocacy communities, and many women had expected the advisory panel to overturn the consensus report.

``There is a fair amount of agreement that there is some benefit'' to mammograms for women in their 40s, said Barbara K. Rimer, professor of community and family medicine at Duke University Medical Center in Durham, N.C. and chair of the NCAB. ``But we need to not overstate it.''

``I believe we can explain what the data show and what the limitations of the data are,'' she said. ``Women need to understand the benefits and downsides of mammograms and make informed decisions.''

The NCAB reviewed the consensus report and eight randomized clinical trials conducted in the United States, Sweden and Canada.

A review of research data suggests that, at most, screening women in their 40s would reduce their risk of death by 17 percent, according to Donald Berry, a professor at the Institute of Statistics and Decision Statistics at Duke University in Durham, N.C., who spoke at the meeting.