Research must be increased and improved in five key areas of women’s health before any kind of recommendations for screening can be made, according to the U.S. Preventive Service Task Force’s annual report to Congress.
Specifically, more data is needed before recommendations can be made on:
• Screening for intimate partner violence, illicit drug use, and mental health conditions.
• Screening for thyroid dysfunction.
• Screening for vitamin D deficiency, vitamin D and calcium supplementation to prevent fractures, and screening for osteoporosis.
• Screening for cancer.
• Implementing clinical preventive services.
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Regarding mental health conditions, USPSTF identified research gaps in the optimal timing for mental health screening in pregnant women, the effectiveness of treatment in pregnant and postpartum women, the development of risk-assessment tools to identify patients at risk for suicide, the effectiveness of tailored therapies in at-risk patients, and linkages between clinical and community resources to help patients at risk for suicide.
Pertaining to breast cancer, the task force found research voids in the effects of new technology (3-D mammography) on improving long-term health outcomes in breast cancer patients, and evidence gaps in the long-term health outcomes in women with dense breasts who receive screening beyond mammography. The task force also identified research deficiencies in the effectiveness of new screening methods and treatment strategies for ovarian cancer. Finally, the task force identified research gaps in the optimal approach to cervical cancer screening using new technologies, in the harms of different screening and treatment options, and in the effect of human papillomavirus vaccination on cervical cancer screening.
Regarding thyroid dysfunction, the task force found a lack of evidence that would help in understanding the natural history of untreated, asymptomatic thyroid dysfunction; a void in the effectiveness and harms of treating thyroid dysfunction in adults without symptoms; and research gaps in the treatment trials of watchful waiting using health outcomes, such as cardiovascular-related morbidity and mortality.
The task force also identified evidence gaps in the benefits of vitamin D and calcium supplements in reducing the risk of fractures in postmenopausal women, the effectiveness of different preparations of vitamin D or different calcium formulations, and the effectiveness of vitamin D supplementation in diverse populations.
Identifying the evidence gaps and prioritizing the areas for research will hopefully move public and private researchers to collaborate and target their efforts to address the lack of research, according to the report.
The Affordable Care Act charged the task force with sending an annual report to Congress that identifies gaps in evidence and recommends priority areas that deserve further examination; this year’s report focused on women’s health. The ACA also requires that preventive care services and screenings given an A- or B-level recommendation by the task force be covered at no cost to the patient.
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