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New Mammogram Guidelines Raise Concerns
On Monday the U.S. Preventive Services Task Force (USPSTF) released a report containing new guidelines regarding breast cancer screenings, which became a subject of controversy and criticism. According to the updated recommendations, women are advised to start regular screening for cancer at the age of 50, not 40. Furthermore, women between the ages of 50 to 74 are encouraged to reduce their mammogram screenings from once a year to once every two years. The panel also suggested that it is unnecessary for women to perform breast self-exams.
Some women are understandably concerned about the new guidelines and the effect these guidelines might have on women's health and health insurance. Critics of the guidelines are quick to point out that the lives of numerous women in their 40s were saved by timely detection of cancer through a mammogram screening. But according to the report, mammogram screenings prevent one death out of every 1,904 women ages 40 to 49, so the risks involved in the mammogram screening actually outweigh the benefits. It goes without saying that women whose lives were saved by the procedure would strongly disagree with such a claim.
However, it is also hard to deny that the report's recommendations have a legitimate foundation. For several years now, most cancer experts and advocacy groups have been recommending raising the age at which to start mammogram testing. There are serious risks involved in getting mammograms that should be considered. Dr. Diana Zuckerman, president of the National Research Center for Women & Families, lists radiation and overtreatment as major health threats associated with mammograms. "Increasing the age of mammograms to age 50 for most women, and reducing the frequency to every two years could save lives because it would drastically reduce radiation exposure," says Zuckerman.
Overtreatment is a result of false alarms, which comprise 90 percent of worrisome mammogram findings and can lead to unnecessary procedures, according to Zuckerman.
Regarding the recommendations against breast self-exams, there is no scientific data to support effectiveness of self-exams in breast cancer prevention. Zuckerman writes that "by the time a cancer is large enough to be felt in a self-exam, it will soon be found anyway, in the shower or while dressing." Also, self-exams can lead to numerous false alarms.
One important thing to keep in mind is that the USPSTF guidelines are directed at the average woman. In fact, women who are at a high risk of breast cancer due to hereditary or environmental factors are strongly encouraged to start getting mammograms in their 40s and sometimes earlier.
Still, a concern remains that these new guidelines will negatively impact health care coverage. Will insurance companies continue covering mammograms for women under 50? According to the New York Times, "the guidelines are not expected to have an immediate effect on insurance coverage but should make health plans less likely to aggressively prompt women in their 40s to have mammograms and older women to have the test annually." As of right now, insurance companies maintain that they will continue covering mammogram testing, and private insurers are "are required by law in every state except Utah to pay for mammograms for women in their 40s."
Clearly feminists will need to stay on top of this issue to ensure that insurance companies don't use the new guidelines as an excuse to further deny women critical health care.
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women need to be better advocates for themselves and they are not. neither are the organizations that represent them in washington, d.c.
you, individually, have to get on the phone or start writing your representatives and congressmen who are trying to pass this huge government run health bill in the face of the greatest financial calamady since the great depression and tell them what you think about it! they threw out this test run of an article on mammograms to see what response they would get and i think if you do not advocate for yourselves, than no one will...not even n.o.w. as i have seen them very quiet when this administration came into office.
rwv, m.d.
rwv, m.d.
"The work of the U.S. Preventive Services Task Force (a group of independent practitioners and researchers) has been ongoing for many years and has nothing to do with the Senate bill. . . . These recommendations have always been just that -- recommendations and some doctors don't agree with them. The right for a patient to discuss with her doctor tests and treatments will always be there."
Outrage over the new recommendations is, in essence, fighting for a mediocre screening technology. We've been sold a bill of goods for decades that mammography is the silver bullet that saves lives. Sadly, that's wrong, and has been proven wrong for well over a decade. Mammography only finds (potential) tumors. It does not treat or cure them.
My hope is that the public discourse -- and public policy -- will shift to the next level: funding and finding screening technologies that ARE effective for a broad population....
Also, screening is only as effective as our ability to adequately treat it. Unfortunately, we're not anywhere near there on the treatment front. Proper treatment -- and ensuring that every woman has access to this care -- is what saves lives.
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