Financial Conflicts of Interest Among Authors of Clinical Practice Guidelines for Routine Screening Mammography

J Am Coll Radiol. 2019 Nov;16(11):1598-1603. doi: 10.1016/j.jacr.2019.05.005. Epub 2019 May 29.

Abstract

Purpose: Financial conflicts of interest (FCOIs) may influence or undermine the credibility of clinical practice guidelines or society recommendations. Given the wide regard of such publications, understanding the prevalence and extent of FCOIs among their authors is essential.

Methods: The most current guidelines containing recommendations for breast cancer screening from the US Preventive Services Task Force, American Cancer Society, American College of Obstetricians and Gynecologists, International Agency for Research on Cancer, ACR, and American College of Physicians were retrieved from their respective organizational websites. Industry payments received by authors were then extracted using CMS Open Payments database (OPD), and the values and types of these payments were evaluated. Finally, financial disclosures were compared with open payments.

Results: Among a total of 43 authors and 7 guideline documents, 14 authors (33%) received at least one industry payment according to OPD payment records, whereas a majority of 29 authors (67%) had none. The median total payment from all sources across all breast imaging guidelines was $0 (interquartile range, $0-$84). Four authors (9%) declared at least one significant FCOI, five (12%) received more than $5,000 from a single company in a single year, and one author had a significant FCOI (2%) identified from OPD records but not disclosed within the guideline document.

Conclusions: These findings suggest that FCOIs likely have little to no influence on the adoption of consensus recommendations regarding routine screening mammography for all cohorts of women.

Keywords: Mammography; breast cancer screening; clinical practice guidelines; financial conflicts of interest; open payments; preventive health care; public.

Publication types

  • Comparative Study

MeSH terms

  • American Cancer Society / economics
  • Breast Neoplasms / prevention & control*
  • Conflict of Interest / economics*
  • Disclosure*
  • Early Detection of Cancer / methods*
  • Female
  • Financial Support
  • Humans
  • Mammography / economics*
  • Mammography / statistics & numerical data
  • Mass Screening / organization & administration
  • Practice Guidelines as Topic*
  • Preventive Medicine / organization & administration
  • Publications / economics
  • Publications / statistics & numerical data
  • United States