New Mammogram Guidelines by Government Task Force: Just the Beginning?

There is a new recommendation being made by a government task force on mammogram guidelines for women. For many years, it has been recommended that all women should have a mammogram yearly after the age of forty. The U.S. Preventive Services Task Force released their new guidelines saying women should have mammograms every two years after the age of fifty.

Not only is this contrary to the long standing mammogram recommendations by the American Cancer Society, but this new guideline is being challenged by the society. Dr. Otis Brawley, chief medical officer of the American Cancer Society disagrees with the new mammography guidelines saying, "This is one screening test I recommend unequivocally, and would recommend to any woman 40 and over."

Dr. Diana Petitti, vice chair of the government panel recommending the new mammogram guidelines claims, "The benefits are less and the harms are greater when screening starts in the 40s." The panel argues that early screening often causes false positives, requiring stressful biopsies. Some believe this creates unnecessary expenses to our taxed health care system when these false positives require biopsies.

This new guideline is causing confusion among doctors and patients alike. Many physicians are concerned that the confusion might cause patients to forego any screening due to uncertainties.

Breast cancer is the second leading cause of cancer deaths in American women. In 2009, it is estimated that 40,000 people will die from breast cancer and over 192,000 will be diagnosed. Breast cancer is the most common cancer.

Are we already beginning to see the rationing effects of the nationalized healthcare system that Obama and democrats want so badly to pass? It is clear that early detection in women having mammograms in their forties does save lives. These new guidelines were created based upon probabilities. The panel calculates that the probability of dying of breast cancer after age forty is 3 percent.

Mammograms reduce women's risk of dying from breast cancer in their 40s and 50s by about 15% according to the task force. Women in their forties have denser breast tissue, making the discovery of a tumor more difficult. Screening 1,900 women in their forties will prevent one breast cancer death. Screening 1,300 women in their fifties will prevent one death from breast cancer.

The problem now facing women is that the panel's new recommendations may affect what existing health insurance policies, including Medicaid and Medicare, will pay for when it comes to mammograms and breast cancer screenings. Currently, Medicare is required to cover one mammogram for women ages 35 to 39 and then yearly at age forty. The mammogram guidelines, while not directly able to change Medicare's coverage of mammograms, can influence congress to change the law or the secretary of Health and Human Services can change the coverage of mammography for women under forty. Stephen Finan of the American Cancer Society says the new mammogram guidelines could affect laws in West Virginia because their mammogram coverage laws are tied to the task force's recommendations. This, then, appears to confirm the fears of those against nationalized health care. Government panels are making recommendations that will possibly affect the payment of health services, regardless of the doctor's recommendation to their patients.

At Johns Hopkins Avon Foundation Breast Cancer Center, 27% of the 640 cases of breast cancer found last year were found in women in their forties. Dr. Nagi Khouri of Hopkins fears that insurance companies will be enticed not to cover routine screenings for women in their forties due to the task force guidelines. He states, "We may be at the beginning of a bad trend." Just ask Lillie Shockney, administrative director of the foundation at Hopkins, who said, "If I had waited until I was 50, I wouldn't be here." Shockney, who has survived breast cancer twice, had her first breast cancer tumor discovered by mammogram at age 38.

Many physicians and medical groups insist they will continue to recommend mammograms yearly for women over age forty. Dr. Carol Lee, an American college of Radiology spokeswoman believes that reducing the costs of healthcare may have played a role in the task force's decision on mammogram guidelines. Lee stated, "Screening isn't perfect. But it's the best thing we have. And it works."

The American College of Obstetricians and Gynecologists is also not in favor of the new mammogram guidelines. Dr. Hal Lawrence believes women in their forties find significant benefits in breast mammography stating, "We think that women deserve the benefit."

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U.S. Preventive Services Task Force