Mammogram guidelines under debate

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SALT LAKE CITY -- A panel of U.S. doctors is reigniting debate over when women should be screened for breast cancer.

The U.S. Preventive Services Task Force has released new guidelines for mammograms, questioning how useful getting one before the age of 50 can be for women.

“It’s important women understand both the potential benefits and potential harms,” said Dr. Kirsten Bibbins-Domingo, Vice Chairperson of the task force.

In a 7-minute video posted online, Bibbins-Domingo explained the findings, which highlighted problems the task force said stem from too many screenings at a young age.

Under their recommendations, women between the ages of 50-74 should get a mammogram every two years.  However, they advise that the decision to start screening before age 50 should be made on an individual basis, between a woman and her doctor.

According to the USPSTF, this is in large part because of the increased risk for false-positives and unneeded diagnosis and testing they found accompanied screenings of women in their 40s.

“Because the risk of developing breast cancer is lower in this age the likelihood of benefitting from screening is smaller,” Bibbins-Domingo said. “And the risk of harm is greater than for women over age 50.”

But the report is facing harsh criticism from some in the medical community.  The American Cancer Society has recommended annual mammograms for women over the age of 40.  It’s a practice many feel has worked well for patients.

“Mammography could save their lives,” said Dr. Brett Parkinson of Intermountain Medical Center.

Parkinson, a radiologist, is the imaging director at IMC’s breast care services.  According to him, early detection and screening have played a key role in helping his clients.

“One in six of the diagnoses that we make are in the 40- 50-year-old age group,” Parkinson said. “And more than half of those we find on screening. So, I know that we have made a difference.”

It’s a concern that was raised back in 2009 when the task force made essentially the same recommendation, leaving many wondering if the service would no longer be covered by insurance.  At the time, then Health Human Services Secretary Kathleen Sebelius addressed the controversy.

“They do not make policy decisions. They don't make coverage decisions,” Sebelius said. “That's really the critical piece."

In an effort to assuage similar concerns Tuesday, a HHS spokesperson released the following statement:

“The U.S. Preventive Services Task Force (USPSTF) is an independent group of experts. The recommendations it released are draft and are open for public comment. Because the recommendations are a draft, nothing has changed as far as access to mammograms or other preventive services that insurers are required to cover with no cost sharing.”

The draft will undergo public comment and revisions before it is published online and in a peer-reviewed scientific journal.  The recommendations are meant to serve as guidelines for the public, so they can make education choices about health, according to USPSTF.

The public is invited to comment on the task force’s draft through May 18 at screeningforbreastcancer.org.

1 Comment

  • Miss Feminist

    Too bad Utah is the only state that doesn’t require that private insurance companies, Medicaid, and public employee health plans provide coverage and reimbursement for mammograms.

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