Panel clarifies mammogram advice

Says women in 40s can benefit from screening

By Nicole Gaouette
Bloomberg News / December 3, 2009

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WASHINGTON - Women in their 40s should start mammograms when they want, according to members of a US panel who said their earlier recommendation on breast cancer screening was “poorly worded.’’

The guidance was misunderstood, and its communication made it seem the panel advised that screenings weren’t needed for patients younger than 50, physicians with the Preventive Services Task Force told a House hearing yesterday while the Senate debated an overhaul of US health care. The panel said it meant to say that screening is more effective for those ages 50 to 74.

The initial release of the task force recommendation on Nov. 16 led to protests by advocacy groups. Republicans said the suggestion was evidence the Democratic-sponsored revamp would lead to rationing of medical care.

Advocacy groups welcomed yesterday’s clarification, while Democrats at the hearing of the House Energy and Commerce subcommittee on health said the proposed overhaul would promote use of scientific evidence in determining the best medical care.

“Many women will decide to have mammogram screening at age 40,’’ said Diana Petitti, a physician and vice chairwoman of the task force. “The task force supports those decisions. The task force communication was poor.’’

The advisory group of physicians said annual mammograms for women in their 40s have more drawbacks than benefits because of false-positive tests that can cause unnecessary biopsies and anxiety. Women should start screening every two years once they turn 50, the group said, unless they have higher risk factors for breast cancer.

Petitti said the task force also found that the benefit of screenings “is larger in older women than in younger women.’’

Otis Brawley, the chief medical officer at the American Cancer Society, said the task force was telling women that mammograms save lives, “just not enough of them to recommend that all women over 40 get screened.’’

The cancer society disagrees with that position, Brawley said.

Breast cancer is the second-leading cause of cancer-related death among US women, after lung cancer, killing an estimated 40,170 women this year, according to the National Cancer Institute.

Representative Henry Waxman, a California Democrat and chairman of the Energy and Commerce Committee, said in a prepared statement he had “no doubt’’ the panel was “driven by science and by the interpretation of science - and not by cost or insurance coverage or the ongoing health-reform debate.

Representative John Shimkus, an Illinois Republican, said language in the health care legislation meant the panel’s recommendation would eventually be used to ration care.