According to the
United States Preventive Services Task Force (a panel of experts appointed by the federal
Department of Health and Human Services to provide guidance for doctors, insurance companies and...watch out, folks...
policy makers), all women except for those specifically designated as "high risk" should begin having mammograms at age 50 rather than age 40. Furthermore, they should have them every two years rather than every year. And they should stop giving themselves breast examinations.
Interestingly, it was only seven years ago that the USPSTF conducted its last study. At that time, the panel counseled women to have mammograms every year, beginning at age 40. True, the members of the group are now different, but could the data they investigated have changed that much in seven years? Maybe it has, but my initial reaction was to suspect that the health care rationing I've feared under Obama's plan has already begun. Am I crazy?
So far, the American Cancer Society and the American College of Radiology have stridently disagreed with the new guidelines and are refusing to back them up. Both organizations will continue to espouse the old regimen. On the other hand, the National Cancer Institute has promised to reconsider its recommendations due to the USPSTF's findings.
Let's face it. Right now, Medicare is required to pay for annual mammograms, and so are private insurers in every state but Utah. Under the new guidelines, that coverage will likely change.
According to Dr. Karla Kerlikowske, a professor at UCSF, "the message is to get 10 mammograms in a lifetime, one every two years, beginning at age 50" in order to minimize potential harm and maximize potential benefit. The task force concluded that one cancer death is prevented for every 1,904 women between the ages of 40-49 who are tested yearly. That number changes to one death averted for every 1,339 women aged 50-59 and tested yearly, and one death for every 377 women aged 60 to 69 and tested yearly.
To those of you who've hung around here a while, it's no secret that I hate getting mammograms, and I can't honestly say that I'd be sorry to give up having them every year. But I've also had several friends, diagnosed under age 50 by yearly mammograms, who would probably not be with us right now without that earlier screening. I've also had friends over 50 whose lives would almost surely have been lost from fast-growing forms of breast cancer had they not been tested annually. That looks like some pretty big downside from where I'm sitting.
I've always felt some concern about the amount of radiation we receive in our yearly mammograms, but so many of my friends are getting breast cancer that I'm going to side, for now at least, with the American Cancer Society. Ideally, we would all get an ultrasound every year, which works better diagnostically and is entirely free of radiation. Barring that, I've read that the newer mammography machines are both improving results and lowering levels of radiation, thus minimizing potential overexposure.
It's a hard one, and maybe I'm just conditioned to think we need yearly mammograms, but I still can't help feeling suspicious. Doesn't this new revelation come just a little too close on the heels of the health care bill? Isn't the coincidence of this timing just a little too convenient?
I'd love for all of you to weigh in here. I could use a reality check!
=)
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