Prevention, Early Detection and Good Health

Rosalyn Sia Baker-Barnes
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Posted by Rosalyn Sia Baker-BarnesNovember 19, 2009 3:03 PM

A new study released by the United States Preventive Services Task Force has women and doctors confused and torn over recent recommendations regarding what age a woman should receive annual mammograms.

For years, the American Cancer Society, physicians, and other government organizations, have recommended that women receive annual mammograms at the age of 40 to prevent breast cancer, which seemingly aided in the early detection of the disease. Now, the task force, a government panel of doctors and scientists, are recommending that most women wait until age 50 to get mammograms and then have one every two years. The study states that beginning to test for breast cancer at age 40 saves few lives and can even harm patients. They point out that if a mammogram gives a false positive, it can lead to anxiety, unnecessary additional testing and biopsies, and exposure to radiation. Mammograms typically produce false-positives in about 10 percent of cases.

Opponents disagree and feel that these new guidelines will only confuse and scare women from seeking the recommended testing. The American Cancer Society posted a statement on its website stating that it would continue to recommend annual screening for all women, beginning at age 40. “It (the guideline) is very confusing and that’s one of the things we’re worried about is that women are already confused, scared, and worried about getting a mammogram because of what they may find out,” said American Cancer Society spokesperson Mary Kathryn Walker.

Breast cancer survivors are also angry about the new guidelines saying that if they didn’t receive mammograms in their 40’s, they wouldn’t be alive today. The American College of Radiology and other experts condemned the change saying the benefits of routine mammograms have been clearly demonstrated and continue to play a key role in reducing the number of mastectomies and deaths. Breast cancer is the most common cancer and the second leading cause of cancer deaths in American women.

The task force guidelines don’t apply to women at high risk for breast cancer, including those with genetic mutations that make them more susceptible to the disease.

Diana B. Petitti, vice chairman of the U.S. Preventive Services Task Force says “We’re not saying women shouldn’t get screened. But we are recommending against routine screening. There are important and serious negatives or harms that need to be considered carefully.”

The task force’s guidelines also recommend against teaching women to do regular self-exams, something that that American Cancer Society has been touting for years. The practice was so heavily promoted at one time that the organization distributed cards that could be hung in the shower demonstrating the circular motion women should use to feel for lumps. Recently, the American Cancer Society and other medical groups have backed off promoting breast self-exams because of scant evidence of their effectiveness, even before the new task force guidelines were revealed.

Insurance companies are claiming that coverage will not likely change because of the task force guidelines. In the past, the guidelines issued by the U.S. Preventive Services Task Force, has influenced the stance Medicare and many insurance companies take on healthcare coverage. Opponents of the new guidelines fear that the findings could spur insurers to deny coverage of annual mammograms and breast tests given to women under 50. “Screening isn’t perfect, but it’s the best thing we have and it works,” says Dr. Carol Lee, a spokesperson for the American College of Radiology. She also suggested that cutting health care costs may have played a role in the recent decision, but task force vice chairman Petitti said the task force does not consider cost or insurance in its review.

Whether or not you believe women’s health is again under fire, it is important to know your family medical history and routine visits to your doctor are your best tools against any type of disease, including cancer. The new task force guidelines are just that, guidelines. Mammograms, like all medical interventions, have risks and benefits. These new guidelines will hopefully help spur conversations and assist women in making the best decision for their personal circumstances.

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