Mammogram flip-flop

Recently, the U.S Preventive Services Task Force (USPSTF) decreed that women ages 40-50 shouldn’t seek routine mammograms in the fight against breast cancer. They claim that these women may experience additional pain, expense and worry because of follow-up scans and biopsies due to positive, or false positive tests. One strange thing about this, is the fact that 6 months and 6 days ago, the Washington Post ran an article titled “Mammogram rates seem to be slipping”.  In it they describe how the number of women getting routine mammograms has dropped slightly in recent years. 

A National Institutes of Health study published in 2007 found that while the percentage of women 40 and older having yearly mammograms grew steadily between 1987 and 2000, those rates leveled off for three years and then declined. “The 2010 target for all women, 70 percent, was met in 2000, but the proportion fell to 66 percent in 2005,” says Stephen Taplin, a senior scientist at the National Cancer Institute. 

…

The downward trend, however slight, has breast cancer experts worried. Mammograms can enable physicians to diagnose the disease at early stages, often before a lump can be felt. “When breast cancer is detected early, it often can be treated before it has a chance to spread in the body and increase the risk of dying from the disease,” says Katherine Alley, medical director of the breast health program at Suburban Hospital in Bethesda.

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<AND HERE’S THE RUB!!!!!>

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 The U.S Preventive Services Task Force, an independent panel of experts working under the Department of Health and Human Services, recommends that women older than 40 get a mammogram every one to two years. The task force finds the test most helpful for women between ages 50 and 69, for whom it says the evidence is strongest that screening lowers death rates from breast cancer. Other groups, including the American Medical Association, suggest a more rigorous schedule, saying the test should be done every year; insurers often pay for annual tests.

Catch all that?  In May, the USPSTF said you should start at 40….now it’s 50?  Why the change of heart when most other cancer groups believe 40 is the right age? 

What is TRULY amazing about this is the timing.

Think about this.   At exactly the moment when a 700 billion dollar health care plan balloons to over a trillion (which usually means MANY trillion in government speak) the USPSTF gives cause for cancelling benefits of women aged 40-49.  It hasn’t even passed the Senate, and services are already being cut.  But, you say they’re not being cut, this is just a recommendation from a government panel.  When the government puts their budget together trying to anticipate the cost, they will not include mammogram costs because they’re “NOT GOING TO BE COVERED” based on this report.  So, they’ll say it costs a certain amount, pass the bill, get complaints about the lack of screenings, and reinstate them next year….knowing all along they planned to pay for it and that the true cost of their health care plan is even higher.  Early detection is key, and has prevented many deaths.  Politics has no place in health care.

“At this time, it is not possible to be sure which very small breast cancers found by screening will cause problems and which breast cancers will not,” says the NCI’s Taplin. Therefore, he says, most of the medical community continues to rely on mammograms as a detective tool, but each woman has to decide for herself, together with her physician. “One thing we do know,” he adds, “is that if women opt for mammograms, it does have to be done regularly, since they are of greatest value when physicians can compare changes that occur over time.

In May, it was not possible to be sure, but now in November, we’re sure.  Pfft.

edited 11/19/09:  After I posted this, the White House made a statement through Kathleen Sebelius, the Secretary for US Health…

“The recommendations have caused a great deal of confusion and worry among women and their families across this country. Our policies remain unchanged. I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action.”

I hope she is right.