COMMENTS AND RESPONSES The Background Review for the USPSTF Recommendation on Screening for Breast Cancer TO THE EDITOR: The recent changes to the U.S. Preventive Services

Task Force (USPSTF) breast cancer screening recommendations are welcome and reflect the best available current evidence (1). The updated systematic review by Nelson and colleagues (2), which is the basis for the changes, concurs substantially with the relevant Co-chrane review on mammography and, indeed, the Cochrane review of breast self-examination or clinical examination (3, 4). Persons raising concerns about Nelson and colleagues ’ review should be reassured that the summary breast cancer mortality reduc-tion of 15 % from screening mammography is similar to that pre-sented in the Cochrane review, which was performed independently, and leads to similar estimates of the numbers needed to invite for examination to prevent or delay 1 death from breast cancer. Perhaps the most important addition to the revised USPSTF recommendations is the examination of harms from screening, in particular false-positive results and overdiagnosis. Again, the figure