17th Nov 2009

What’s behind the new breast cancer screening recommendation?

The news has been buzzing about the recent change in recommendations for breast cancer screening. The old guidelines suggested that women begin having mammograms beginning at age 40, and that they be screened once each year. Now the U.S. Preventive Services Task Force says that women should wait until they are 50 years old to begin breast cancer screening, and that they should only have an exam done every two years.

This new recommendation comes as a shock to anyone who is familiar with breast cancer, which is treated most effectively when detected early. Outrage at the new breast cancer screening standard has come especially from women who are survivors of breast cancer, and whose ability to defeat the disease came because they were getting regular screenings beginning at age 40.

This sudden drastic change definitely seems suspicious. Logically connecting the dots would tell a rational person that somehow this new recommendation is linked to the healthcare reform debate that has been a hot topic over the months since Barack Obama took office. His determination to overhaul what has been the best health care system in the world now seems to be anything but benign. Doctor Peter Jokich of the Rush University Medical Center said in an interview with ABC News that the new guidelines are about “money and politics” and show symptoms of “the beginnings of rationing care”. Dr. Susan BoolBol, Beth Israel Medical Center commented that “[The new guidelines] will set breast cancer back about 30 years.”

The American Cancer Society quickly rebutted the new guidelines, saying that it will continue to promote the existing policy. However, the collateral damage to many women in the United States may already be done when considering the response to the new recommendation. Many offices who screen for breast cancer are seeing appointment cancellations as a direct result of the announcement.

If indeed these new guidelines are a foreshadowing of the demise of the US health care system as our freedoms are sacrificed one at a time on the alter of liberal progressivism, it comes as a surprise to me that the announcement would be made before the camel gets its nose far enough into the tent to have any traction. I don’t know what was said in the meetings that led to these new guidelines, but they are obviously out of stride with the great majority of those who are in the know in the medical field. Could the panel have simply made a mistake, as if it’s an isolated body out of touch with what’s going on in medicine and cancer research? The task force’s recommendation statement includes a section entitled “Harms of Detection and Early Intervention”, citing “psychological harms”, unnecessary tests, and “inconvenience” for women whose mammogram tests result in false positives. That sounds like a parent asserting that her infant shouldn’t be warned to stay out of the street because it might hurt his feelings. And besides, there may not even be a car coming for a long time.

One might argue, “But it’s just a recommendation. Nobody is forced to follow it.” Well, tell that to the insurance companies who may use this recommendation as a way to limit their coverage to screenings that fall within these guidelines. There are programs and policies that are greatly affected by the recommendations of a such an influential body as the USPSTF.

For those of us who have known for a long time that there are people in Washington whose intentions with health care, bailouts, and other aspects of American society are not what they would like us to believe, this new health care rationing recommendation is another warning about what could be ahead.


Who are the members of the U.S. Preventive Services Task Force who contributed to this new recommendation? Here is a list of them. This list was obtained from the US Agency for Healthcare Research and Quality website. If you have the time and can find a way to ask one of these people about the new recommendation, let us know what you find out.

  • Ned Calonge, MD, MPH, Chair (Colorado Department of Public Health and Environment, Denver, Colorado)
  • Diana B. Petitti, MD, MPH, Vice-Chair (Arizona State University, Phoenix, Arizona)
  • Thomas G. DeWitt, MD (Children’s Hospital Medical Center, Cincinnati, Ohio)
  • Allen J. Dietrich, MD (Dartmouth Medical School, Hanover, New Hampshire)
  • Kimberly D. Gregory, MD, MPH (Cedars-Sinai Medical Center, Los Angeles, California)
  • David Grossman, MD (Group Health Cooperative, Seattle, Washington)
  • George Isham, MD, MS (HealthPartners, Minneapolis, Minnesota)
  • Michael L. LeFevre, MD, MSPH (University of Missouri School of Medicine, Columbia, Missouri)
  • Rosanne M. Leipzig, MD, PhD (Mount Sinai School of Medicine, New York, New York)
  • Lucy N. Marion, PhD, RN (School of Nursing, Medical College of Georgia, Augusta, Georgia)
  • Bernadette Melnyk, PhD, RN (Arizona State University College of Nursing & Health Innovation, Phoenix, Arizona)
  • Virginia A. Moyer, MD, MPH (Baylor College of Medicine, Houston, Texas)
  • Judith K. Ockene, PhD (University of Massachusetts Medical School, Worcester, Massachusetts)
  • George F. Sawaya, MD (University of California, San Francisco, San Francisco, California)
  • J. Sanford Schwartz, MD (University of Pennsylvania Medical School and the Wharton School, Philadelphia, Pennsylvania)
  • Timothy Wilt, MD, MPH (University of Minnesota Department of Medicine and Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota).

If you’d like to read the entire statement from the USPSTF recommendation statement, you can find it here.