Some Physicians Say New Breast Cancer Screening Guidelines Unlikely To Alter Their Practices

Main Category: Breast Cancer
Also Included In: Primary Care / General Practice
Article Date: 19 Nov 2009 - 6:00 PDT

email to a friend   printer friendly   opinions  

One day after the release of new breast cancer screening guidelines, many physicians and some medical groups are saying that they do not plan to adopt the new recommendations -- which represent a drastic change -- the New York Times reports (Belluck, New York Times, 11/18). The guidelines, released by the U.S. Preventive Services Task Force, said that most women should begin routine mammograms to screen for breast cancer at age 50, not 40 as previously recommended. The task force also said that women ages 50 through 74 should receive mammograms every other year, not annually, and that doctors should stop advising women to regularly examine their own breasts. The guidelines do not apply to women at high risk of the disease (Women's Health Policy Report, 11/17).

The panel noted that screening women between ages 40 and 50 for ten years prevents one cancer death for roughly 2,000 women screened and that mammography in that age range can cause unnecessary stress and anxiety and lead to overtreatment. But Carolyn Runowicz, director of the Neag Comprehensive Cancer Center at the University of Connecticut, said, "My patients tell me they can live with a little anxiety and distress but they can't live with a little cancer." Still, many doctors said they would inform their patients about the recommendations, as well as the fact that several medical groups, such as the American Cancer Society and the American College of Obstetricians and Gynecologists, have chosen not to adopt the new guidelines (New York Times, 11/18).

According to the Los Angeles Times, President Obama and congressional Democrats who support health care reform hope to expand the use of independent government institutions similar to the Preventive Services Task Force to recommend which treatments and practices work best. But the outcry surrounding the task force's mammography recommendations underscores the challenges health reform advocates face in achieving that goal. The reaction to the new guidelines also shows how a "potentially revolutionary improvement in the medical system would almost certainly bring controversy, confusion and uncertainty along with it," the Los Angeles Times reports (Levey, Los Angeles Times, 11/18).

The new guidelines also highlight a debate in the medical community about the benefits and drawbacks of breast cancer screening that has continued for decades. For example, although an NIH panel in 1997 said that routine mammograms for women in their 40s might not be justified based on the risks of the procedure, the Senate then voted 98-0 to urge the National Cancer Advisory Board to endorse routine screenings for women in that age group. According to Maryann Napoli, associate director of the Center for Medical Consumers, the issue of breast cancer screening often is "used by politicians as a way to say they are for women," regardless of whether the policy under debate makes sense (Eggen/Stein, Washington Post, 11/18).

Critics of the new guidelines have suggested that the task force was motivated by costs in reaching its conclusions, though the price of mammography was not a factor that the panel considered (Los Angeles Times, 11/18). Some lawmakers suggested that the panel was influenced by insurance companies that would save money by not having to cover mammograms for women in their 40s. "We can't allow the insurance industry to continue to drive health care decisions," Rep. Debbie Wasserman Schultz (D-Fla.) said. Rep. Frank Pallone (D-N.J.) said Tuesday that the House Energy and Commerce Health Subcommittee will begin hearings on the mammogram issue in December (Washington Post, 11/18).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2009 The Advisory Board Company. All rights reserved.

• Additional
• References
• Citations