Mammogram Recommendations Could Reverse Years of Progress

Is this the start of rationing healthcare coverage?


By Mary Kate Cary, Thomas Jefferson Street blog

I'm upset about the controversial decision by the U.S. Preventive Services Task Force—an agency appointed by HHS, the federal department at the center of healthcare reform—to recommend that women not begin regular mammograms until age 50, and even then, only every two years.

The breast cancer awareness lobby in the United States has spent years convincing women that we must get checked early and often for breast cancer. It's just what you do: Every year I get my teeth cleaned (twice), I get a Pap smear and a mammogram, and get my cholesterol checked. It's part of being a grownup. It's as if they came out and said that seat belts in cars really aren't necessary anymore, or that it's okay for pregnant women to drink tequila again.

According to the New York Times: "The task force concluded that one cancer death is prevented for every 1,904 women age 40 to 49 who are screened for 10 years, compared with one death for every 1,339 women age 50 to 59, and one death for every 377 women age 60 to 69."

No one wants to be the one woman—the one mom, sister, daughter, or friend—whose death was preventable. Who wants to take that chance? Two years is a long time to wait and wonder. I bet most women will pay for a yearly mammogram out of pocket just for the peace of mind. Many paid out of pocket a few years back when the new improved Pap smears came out and insurance wouldn't cover the difference. I know I did.

The task force also recommended that doctors stop teaching patients how to do a self-exam for breast cancer on a regular basis. What? We all know women who have survived breast cancer in their 40s who either found a lump by self-exam or had a bad mammogram. So if you're cutting back on mammograms and telling women to stop the self-exams, what other way is there to find breast cancer?

According to the American Cancer Society, "death rates from breast cancer have been declining since about 1990, with larger decreases in women younger than 50." The improvement in survival rates reflects progress in early detection, increased awareness and, to be fair, better treatments as well. The last thing we should do is reverse that progress by cutting back on early detection.

If this is the beginning of reducing costs as part of healthcare reform—as some pleased observers have called it—why did we start by rationing healthcare for women, especially such a high-profile disease that affects so many of us?

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