New Mammogram Advice and Breast Cancer Research Under the Microscope

What is the U.S. Preventive Services Task Force and why is it Giving New Mammogram Advice?

The U.S. Preventive Services Task Force (USPSTF) was formed in 1984. It is made up of a panel of independent experts that reviews the usefulness of preventative health services and then makes recommendations based on the findings. Since 1998, the USPSTF received sponsoring from the Agency for Healthcare Research and Quality (AHRQ).

As outlined by the AHRQ, when the USPSTF issues a recommendation, it is to be used by primary care physicians in their decision making processes. This puts recently made new breast cancer screening recommendations on par with setting a new clinical standard for health organizations.

What Is the 2009 Mammogram Advice and How Does It Impact Breast Cancer Screening Procedures?

The 2009 breast cancer screening recommendations by the USPSTF differ greatly from previous counsel. New Mammogram advice includes a recommendation against routine mammography for women between the ages of 40 and 49. Physicians may offer or perform this kind of breast cancer screening if there is sufficient evidence to support going against the recommendation. Women between the ages of 50 to 74 years of age should receive biennial mammograms. Physicians are to discourage the practice and teaching of breast self examination.

A Brief History of Time: USPSTF 2002 Breast Cancer Screening Advice and Recommendations

The USPSTF recommended - based on fair evidence from breast cancer research - that starting at age 40, women should receive screening mammography services every 12 to 33 months. The best chance of catching breast cancer through screening was within the age ranges of 50 to 69.

Breast cancer research did not allow for an adequate conclusion on a most favorable screening period or gap for the 40 to 49 age group; thus, the group declined to make a specific breast cancer screening recommendation. Moreover, it was very clear in pointing out that there is insufficient proof to offer a recommendation in favor of - or opposed to - routine clinical breast examinations as a standalone cancer screening tool.

Do 7 Years of Breast Cancer Research Explain the New Mammogram Advice and Breast Cancer Screening Recommendations?

The Washington Post reports that the recommendation against routine mammograms for women between 40 and 49 is not new. Instead, it dates back to 1997. Congressional hearings and a Senate vote pitted the will of the legislature against he expertise of physicians and healthcare field Ph.D.s. Already Congress is revving up for a repeat of the 1997 skirmish, albeit this time against the backdrop of the intensely divisive healthcare debate.

Fox News reports on republican representatives that see the new mammogram advice as being a foreshadowing of the healthcare rationings that Obamacare would provide under a nationalized healthcare scheme. The White House Blog uses this opportunity to aim an attack against Fox News by accusing the media outlet of not adequately censoring misguided opponents of healthcare reform but giving them airtime. When commenting directly on the USPSTF breast cancer screening recommendations, the blog merely states that the panel does not have the power to deny or approve insurance coverage.

In the meantime, the medical establishment is also highly critical of the panel's finding. The New York Daily News states that the American Cancer Society is now pitting its clout against the USPSTF, and already the Mayo Clinic, Baylor College of Medicine and other organizations are lining up behind the American Cancer Society.

A scathing evaluation by Kansas City Star Midwest Voices columnist Larry Marsh outlines that breast cancer research - as well as other studies - are oftentimes done inadequately. With the main concentration on meeting or exceeding FDA guidelines for drug approval or medical procedure sanctioning, statistics and numbers can be massaged and study subjects selected with an outcome in mind.

Where does this leave Jane Doe, middle-aged American and still a little ways away from the age of 50? It leaves her wondering. It also leaves her with a 1 in 8 risk of developing breast cancer in her lifetime and a 1 in 33 chance of dying from it.

Sources
http://www.ahrq.gov/CLINIC/uspstfix.htm
http://www.ahrq.gov/clinic/uspstfab.htm
http://www.ahrq.gov/clinic/3rduspstf/breastCancer/brcanrr.htm
http://www.ahrq.gov/clinic/uspstf/uspsbrca.htm
http://www.washingtonpost.com/wp-dyn/content/article/2009/11/17/AR2009111704197.html
http://www.foxnews.com/politics/2009/11/18/white-house-takes-aim-critics-new-breast-cancer-screening-guidelines/
http://www.whitehouse.gov/blog/2009/11/17/reality-check-beware-what-2
http://www.nydailynews.com/lifestyle/health/2009/11/18/2009-11-18_health_cancer_professionals_breast_cancer_survivors_critical_of_new_mammogram_gu.html
http://voices.kansascity.com/node/6588