The Mammogram Debate
The U.S. Preventative Services Task Force released new guidelines on breast cancer screening. It has caused and uproar among doctors and women alike. The new guidelines state that women at average risk for breast cancer should wait to start getting mammograms until age 50 instead of the current recommended age of 40. It also states that women ages 50 to 74 should have a mammogram every 2 years instead of the current once a year and is discouraging doctors from advising their patients from doing self breast examines. Also the U. S. Preventative Services Task Force also states that mammograms should end when a women is over the age of 74. These guidelines which are nonbinding are to stop or reduce over treatment. The task force states that screening can lead to false-positives, radiation exposure, and psychological harm. We have always been told that catching a cancer early will mean a better chance of survival. Dr. Judi Chervenak an ob-gyn states " Catching something early may mean a woman may not need as aggressive a therapy. If we have a modality that can pick up the disease early,why can't woman have it"? She goes on to state " The risk of false - positives that the task force points out is insulting to a woman's intelligence". Women understand the risk of false-positives, and most women would risk a false-positive to have early detection of breast cancer. It's certainly better than no detection at all or late stage detection when hope is all but lost. I know I would.
Will My Insurance Pay
The guidelines do not prevent anyone from getting a screening mammogram but it's still not known if the new guidelines will affect the coverage from insurance companies and other health providers. The U.S. Preventative Services Task force is influential in guiding policy but it remains to be seen whether insurance companies will pay if a woman is under the age of 50. The new guidelines are for screening and will not affect women who are at high risk for breast cancer or have a suspicious lump and are under the age of 50. American Cancer Society national volunteer president Dr. Elizabeth T.H. Fontham states " There is a good chance that Medicare and private insurers will stop paying for annual mammogram screenings for women in their 40's and over the age of 74". The American Cancer Society recommends mammogram screenings for women starting at age 40 and will continue to recommend the same. In a joint statement the American College of Radiology and the Society of Breast Imaging say these new guidelines may very well cost womens lives. Calling the new guidelines a" cost cutting measure" the American College of Radiology states, " 2 decades of decline in breast cancer mortality could be reversed and countless American women may die needlessly from breast cancer every year". Mammograms have saved many women's lives in the 40 to 49 age range.
The U.S. Preventative Services Task Force goes on to say that they also recommend that women over the age of 74 should not get mammogram screenings. A women's chance of getting breast cancer increases with age. The U.S. Preventative Services Task Force acknowledges this but goes on to say that the benefits of screening are not as great for older women because they tend to have breast cancer that responds well to treatment. But yes the older we women get the greater the risk of breast cancer. The U.S. Preventative Services Task Force goes on to say that the risk of overdiagnosis and treatment is greater in older women than in younger women because older women have an increased risk of dying from other causes. HUH!! I have read this over and over and it seems a contradiction to me. Maybe I'm wrong, I'm not a doctor but the way I see this is they acknowledge that older women are at a greater risk for breast cancer but because they also have an increased risk of dying from other causes the breast cancer screenings will stop. I am appalled. And again maybe I'm wrong, maybe I'm overly sensitive to this topic, but isn't preventative medicine cheaper than a full blown case of cancer and the treatments involved?? For decades the numbers of women dying from breast cancer has decreased because of early detection. Early detection is key to many different cancers. I know a few women who were diagnosed with breast cancer in their 40's. And they have been saved because of early detection. So what happens now? We will see in the next 10 years or so what the mortality numbers show. I can't help but think they will go up. Scary isn't it??