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Survey Reveals Consequences of USPSTF Mammography Recommendations

February 23, 2010
Written by: , Filed in: Breast Imaging
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A recent Avon Foundation for Women survey confirms what some experts have feared: States are using U.S. Preventive Services Task Force (USPSTF) mammography recommendations to deny women coverage for mammograms, and many women are foregoing mammography care based on the USPSTF recommendations.

According to the Avon national survey of cancer health educators and providers, respondents from more than a dozen states reported changes in their states’ breast and cervical cancer early detection programs following the USPSTF recommendations, including the elimination of early screening programs for women under age 50. Avon reports that California, New York, Florida, Illinois and Michigan are among those states that have changed their breast cancer screening programs since the USPSTF released its guidelines. Respondents also reported a decline in the number of women under 50 seeking mammograms and stated that many women already reluctant to have a mammogram are using the guidelines as their rationale to put off screening.

“Allowing a small number of people with no demonstrated expertise in breast cancer care to make recommendations regarding diagnosis of the nation’s second leading cancer killer makes no scientific sense, and has set a off a chain of political and clinical events that many women may ultimately pay for with their lives,” said James H. Thrall, MD, chair of the American College of Radiology Board of Chancellors. “Lawmakers at all levels need to act now to ensure that these recommendations do no further damage, and that women have full and ready access to mammography.”

The federally funded and staffed USPSTF includes representatives from major health insurers, but no radiologists, oncologists, breast surgeons, or any other clinicians with demonstrated expertise in breast cancer diagnosis or treatment. Despite their own analyses that screening annually beginning at age 40 saves the most lives and most years of life, the Task Force recommended against routine mammography screening for women 40-49 years of age, against annual mammograms for women between 50 and 74 (in favor of only every other year), and said there was insufficient evidence for breast cancer screening in women over 74. These recommendations run counter to the Task Force’s own data and are out of touch with the long-proven policies of the American Cancer Society, American College of Radiology and other experts in the field.

“Breast cancer experts have explained why the USPSTF recommendations are scientifically mistaken and the recommendations have been disavowed by the Secretary of the Department of Health and Human Services and in Congressional legislation. Any action to curtail mammography coverage or discourage women 40 and over from seeking routine mammography based on the USPSTF recommendations is unjustifiable and will result in unnecessary breast cancer deaths,” said Carol H. Lee, MD, chair of the ACR Breast Imaging Commission.

Source: American College of Radiology

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