prevention services, and the U.S. Task Force on Community Preventive Services is assessing the effectiveness of interventions aimed at communities. USPSTF is an ad hoc independent panel of private-sector experts in primary care and prevention convened by the U.S. Public Health Service’s Agency for Healthcare Research and Quality (AHRQ). USPSTF evaluates scientific evidence of the effectiveness of clinical prevention services (e.g., screening tests, counseling, immunization, and chemoprophylaxis) and produces age- and risk factor-specific recommendations for the services that should be included in a periodic health examination. USPSTF is supported by outside experts, two Evidence-Based Practice Centers (groups that systematically synthesize available literature), and liaisons from the major primary care societies and from U.S. Public Health Service agencies. Currently, the third USPSTF, convened in 1998, is issuing recommendations updating its 1996 Guide to Clinical Preventive Services (www.ahrq.gov/clinic/cps3dix.htm).

The 15-member independent, nonfederal Task Force on Community Preventive Services first met in 1996 and issued a number of reports, among them Recommendations Regarding Interventions to Reduce Tobacco Use and Exposure to Environmental Tobacco Smoke (Task Force on Community Preventive Services, 2001).

Other agencies within the federal government such as the Centers for Disease Control and Prevention (CDC) and AHRQ have been at the forefront in identifying effective prevention intervention strategies. CDC, for example, has issued three guidelines aimed at improving the health of school-age children: (1) CDC’s Guidelines for School Health Programs: Promoting Lifelong Healthy Eating (www.cdc.gov/nccdphp/dash/nutguide.htm), (2) Guidelines for School and Community Programs to Promote Lifelong Physical Activity Among Young People (CDC, 1997a), and (3) Guidelines for School and Community Health Programs Preventing Tobacco Use and Addiction (www.cdc.gov/nccdphp/dash/ptuaaag.htm). In 2000 AHRQ helped issue an update of its 1996 smoking cessation guideline that provides exhaustive information on best practices for clinicians (http://www.surgeongeneral.gov/tobacco/systems.htm). Another activity that has provided guidance regarding certain cancer prevention interventions is the National Cancer Institute’s (NCI’s) Consensus Development Conference process. Here, expert panels convene for a few days to review a synthesis of the literature and produce a consensus statement. In the area of cancer prevention and early detection, recent statements are available for breast cancer screening for women ages 40 to 49 (1997),1 cervical cancer (1996), and ovarian cancer screening, treatment, and follow-up (1994) (http://odp.od.nih.gov/consensus/cons/cancer.htm).

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The controversy surrounding this statement is described in Chapter 4.



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