What I find different among each of the guidelines

The ACS provides guidelines based on multiple factors, including sex, age and socioeconomic status. Furthermore, the guidelines discuss issues related to early detection like associated risks. The USPTFS guidelines incorporate recommendations from other reputable organizations like the American Academy of Pediatrics, The American Cancer Society, American College of Preventive Medicine, and the American Medical Association, thus making it an authoritative source. ACOG guidelines are comprehensive and provide information in three different categories, i.e., impact and overview, latest data and life stages and determinants. On the other hand, ACOG guidelines only focus on women’s health. ACOG takes a risk-based approach to determine screening recommendations. AAFP guidelines are less independent as they are based on the recommendations made by the USPSTF.

What might be contradictory among them

The ACS guidelines exclude women under 25 years from getting tested for cervical cancer. They ignore the fact that even women under 25 years may still be at risk of contracting cervical cancer. The USPSTF guidelines provide contradictory opinions in some cases. For example, in terms of mammography screening, the American Cancer Society and ACOG have different screening frequency recommendations for women at different ages. ACOG does not recommend HPV testing for women below 30 years, which contradicts other recommendations such as the ACS that recommends HPV screening from 25 years. AAFP guidelines contradict the USPSTF recommendations on lung cancer screening for asymptomatic individuals. The AAFP guidelines express significant concerns about the costs of recommended single tests in lung screening, given the unknown risks of radiation exposure.  

The guidelines that make more sense to me

The ACS guidelines make more sense because it monitors scientific and medical literature for new evidence that may back alterations in recommended guidelines. It also provides regular updates based on available evidence and related verifiable literature. The USPTFS, on the other hand, strives to provide independent, balanced, objective and scientific recommendations regarding preventive services. This independence makes the information reliable. However, the organization declares that the recommendations are not official government positions, thus questioning the guidelines’ reliability. ACOG provides resources and guidelines that are specific to women’s healthcare. These guidelines are evidence-based and are regularly published in the official journal. The guidelines have a single focus and therefore fail to apply to all genders. These guidelines are based on USPSTF recommendations and are reviewed by the AAFP to determine their applicability.

Explain what changes you might make to the guidelines for a person who refers to themselves with LGBTQ+ gender identification.

All the reviewed guidelines were not LGBTQ inclusive, especially for transgender persons. The guidelines are provided based on two primary identities, i.e., male or female. Screening guidelines can strive to become inclusive by adopting the gender-neutral language. Additionally, the guidelines should provide information on who is eligible for various forms of screening and include the unique needs of LGBTQ individuals. These guidelines should adopt measures like non-binary and trans imagery to direct LGBTQ individuals to relevant information sources.

Smith, R. A., Andrews, K. S., Brooks, D., Fedewa, S. A., Manassaram‐Baptiste, D., Saslow, D., & Wender, R. C. (2019). Cancer screening in the United States, 2019: A review of current American Cancer Society guidelines and current issues in cancer screening. CA: a cancer journal for clinicians69(3), 184-210.

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