November 3, 2003

Alfred O. Berg, MD, MPH
Chair, USPSTF
C/o AHRQ
6010 Executive Blvd.
Suite 300
Rockville, MD 20852

Dear Dr. Berg:

The American College of Preventive Medicine (ACPM) is pleased to provide comments on the draft Recommendation Statement, "Screening for Oral Cancer: Recommendations and Rationale" developed by the United States Preventive Services Task Force. ACPM commends the Task Force for addressing this issue.

In response to your solicitation, ACPM is submitting comments written by one of its members, Janet Bates, MD, MPH. Currently Dr. Bates is a Medical Epidemiologist with the Research and Surveillance Program at the California Cancer Registry/Public Health Institute in Sacramento.

Please note that these comments are those of an independent reviewer and do not reflect the official view of ACPM or Dr. Bates' affiliations.

Thank you again for the opportunity to review the draft statement. Please contact me if you have any questions. I can be reached at mab@acpm.org or 202-466-2044, ext. 106.

Sincerely,

Michael A. Barry
Deputy Director

The American College of Preventive Medicine
1307 New York Avenue, NW
Suite 200
Washington, DC 20005
Tel: 202-466-2044
Contact Person: Jennifer K. Bretsch, MS @ ext. 107 or jkb@acpm.org

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Review of the USPSTF draft Recommendation Statement on Screening for Oral Cancer: Recommendations and Rationale.

BY: Janet Bates, MD
FOR: The American College of Preventive Medicine
DATE: November 3, 2003

I have reviewed the materials on the update of the USPSTF recommendations statement on screening for oral cancer. I don't have much in the way of comments as this seems pretty straightforward. As I am understanding it, the USPSTF has changed its rating system, giving screening for oral cancer an "I" instead of the old "C" recommendation. These look basically the same to me, and there have been no new studies since 1996 that would change the rating.

There is a comment in the discussion section of the 1996 recommendations about primary prevention through counseling on tobacco and alcohol risk. Insofar as an oral screening examination provides an opportunity for such counseling, especially among higher risk groups, there may be some benefit which may count as one of the other factors to consider in determining appropriate practice. I think this should be touched on in the discussion, but don't think it would change the rating.