Breast Cancer Screening: Are women just too emotional for mammograms before 50?

BlogHer Original Post

Unless you've been under a rock all week, you have probably heard about the government task force that has recommended new guidelines for breast cancer screening.  It goes something like this...

If you're younger than 50 or older than 75, you no longer have to worry your pretty little head about breast cancer, or getting those pesky boob squishing mammograms.

Hallelujah!  I wonder how long it will be before we go back to giving women Valium for chest pain?  Who needs preventative care when it's not 100% effective anyway?  Hell, just go ahead and give us anti-anxiety meds for all of our ills...I'll betcha we save a bundle on healthcare costs. Women already outlive men by a bunch of years, maybe this will even things out a bit...Isn't equality what we've been cryin about all these years?

OK, I know, I went a little too far with my analogy.  But seriously, this is what's going on...

From Kaiser Health News - Guidelines on Cancer Screening Spark Debate...

On Monday, the United States Preventive Services Task Force recommended that routine mammograms start at age 50 instead of 40, that women receive the test every two years as opposed to annually, and that physicians no longer train women to perform breast self-examination.

Imaging centers saw cancellations for mammograms more than double since the news of these "recommendations" were announced.  I wonder how many of those women may actually have breast cancer right now and will miss the opportunity for early detection and treatment?

I have to admit, I've been having a lot of cynical thoughts running through my head since I heard this disturbing news.  Like...

I can't help but think that if the pharmaceutical companies were profiting from mammograms these recommendations would be suggesting that they begin ten years earlier rather than later.

And then there's this one...

If a healthcare reform bill is going to benefit the insurance industry (and it must - considering all their lobbying dollars), then insurance companies need guidelines that will allow them to reduce the amount of money they shell out for quality health care.

I know these are just thoughts, but when government panels are established to become corporate bean counters of women's health policy, it makes me a little angry.

The thing is, when it comes to healthcare for women - I want to see more choices for women, not less.

Check out this video, it really does a nice job of addressing the problems associated with these new guidelines...

Is healthcare for women under attack?

Was I the only one who was completely shocked to find out that this so called panel of experts had three representatives from insurance companies, but no experts in oncology or breast cancer?

From Feminist Legal Theory - How Many Women Does Breast Cancer Cost?

I am not naive to the fact that cost-benefit analysis plays a role in major agency decisions, particularly in allocation of resources, but this is disturbing. Dr. Otis Brawley, Chief Medical Office for the American Cancer Society, shares my concern. "With its new recommendations, the [task force] is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them.”

. . .

Dr. Cheryl B. Iglesia, the chairwoman of a panel that developed the guidelines, assured the New York Times the releases are not political. However, that certainly does not mean the application will not be. While a universal health care package can mean valuable screenings for the uninsured, continued release of materials like this could mean a reduction in coverage for preventative care.

Not everyone disagrees with these new guidelines...

From Our Bodies, Our Blog - New Mammogram Guidelines Make Sense...

The guidelines are in sync with international recommendations; the World Health Organization recommends starting screening at age 50, and in Europe, mammograms are given to post-menopausal women every other year and detection rates are similar to the United States. During an interview on MSNBC on Tuesday, breast cancer expert Dr. Susan Love said the government’s guidelines bring us into line with the rest of the world and with current research. (Read more at her blog.)

You might be thinking: Wait a moment, isn’t earlier better? Why would delaying detection be in my best interest? I’m going to explain why, but let’s first take a closer look at the guidelines, which were released by the U.S. Preventative Services Task Force (USPSTF), an independent panel of experts in prevention and primary care.

While I agree with much of the facts of this post, I don't agree with most of the conclusions.  In the end, if these guidelines are followed, women will die who might otherwise have lived.  Give women the facts and let them make an educated decision between themselves and their physician.  And if the anxiety of a false positive is too much for them at age 40, then they can wait till they are 50.  But don't establish new guidelines that will allow the insurance companies to deny women the opportunity for early breast cancer detection.  That's just wrong.

Julie Pippert from MOMocrats wrote - Et tu, American College of Obstetrics and Gynecologists?

As much as these organizations argue that this is about science and necessity, deconstruction of the logic reveals a more financially based reasoning.

Dr. Brawley said, "With its new recommendations, the USPSTF is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them. The task force says screening women in their 40s would reduce their risk of death from breast cancer by 15 percent, just as it does for women in their 50s. But because women in their 40s are at lower risk of the disease than women 50 and above, the USPSTF says the actual number of lives saved is not enough to recommend widespread screening."

ACOG has allegedly been working towards these new guidelines for the past decade. It's curious timing to me to release these new guidelines right now, as the health care reform debate rages and a major debate point is providing better equality in health care affordability and access for women.

From Karoli at odd time signatures - Before you get twisted about pap smears and mammograms...

Understand that the recent “news” about screening recommendations for them is being used as a tactic against health care reform.

The other issue I have with these guidelines is with the way older studies were used to come to these new conclusions.  It's my understanding that none of the studies used by this panel included the more accurate digital mammography.  And when it comes to the age group that the panel is excluding from mammograms (30-49), digital mammograms have been found to be much more beneficial.  It seems to me that if recommendations would be made for this group of women to have digital mammograms, even more lives could be saved.  But the panel believes no screening for this age group is better than improved screening?  It really makes no sense at all, unless of course, we consider the fragile emotional state of women.

And it's not just mammograms that are being questioned...

From New York Times - Guidelines Push Back Age For Cervical Cancer Testing

A few facts about cervical cancer...

Between 1955 and 1992, the number of cervical cancer deaths in the U.S. dropped by 74%. The main reason was the increased use of screening with Pap tests. The death rate continues to decline by almost 4% a year.

Nearly all cervical cancer can be prevented with routine Pap tests and by limiting exposure to risk factors.

Here are the mammogram guidelines from the American Cancer Society.

On a lighter note.  This is from Uppity Woman - Make vasectomies illegal and remove prostate exams from insurance coverage...

While we are on the subject of removing unnecessary procedures from health care coverage, we should remove prostate examinations from the health care bill after age 75 as well. Since women don’t need to have mammograms covered at age 75 because they are old, it stands to reason that men don’t need their prostates covered either. Obviously this is not all that important. Obviously, 75 is a perfectly respectable age at which to take what’s dealt to you and get the hell off the planet, just like women will be expected to do. If you insist on sticking around with your nasty old carbon footprint, your exam will “Not be reimbursable”. I will however agree that palliative care for you should be covered, since there will be plenty of women in palliative care now that mammograms won’t be covered between ages 40-49 and after age 75. Oh and by no means do you want to have a prostate evaluation before age 50. If you have any symptoms just stop worrying! I mean, women don’t even need to examine their breasts any longer. If they do and find a lump then they cost money! So just hold on with that drip and Start and Stop stuff guys, we will take care of you soon as you turn 50, mmmmmmkay? It will be much cheaper than saving your asses.

Now don’t be upset guys. Don’t be all emotional about this. Calm down. You’ll feel better about this later. Really, it’s no big deal. Stop with the hysterics. Don’t make a mountain out of a molehill. Be rational. We want to be fair with you, you know? Please don’t be interfering with this wonderful health care reform over something silly. Don’t be selfish!

Also See:

Where do you stand on the mammogram issue?  Will you follow the new or old guidelines?  Do you think these new guidelines are politically motivated?  Should women make up there own minds about whether a mammogram is worth the risk before age 50?  Or are they just too emotional about this kind of stuff?  Let us know what you think in comments.

Contributing Editor Catherine Morgan
at Catherine-Morgan.com and Women4Hope

Comments

In order to comment on BlogHer.com, you'll need to be logged in. You'll be given the option to log in or create an account when you publish your comment. If you do not log in or create an account, your comment will not be displayed.