Routine Mammograms Before 50: Not Much Point

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First, bad choice of title.
Second, have you read the information for yourself? Here are a couple of quotes I found interesting:
Under “Screening for Breast Cancer: Systematic Evidence Review Update for the U.S. Preventive Services Task Force,” November 2009
“Our meta-analysis of mammography screening trials indicates breast cancer mortality benefit for all age groups from 39-69 years, with insufficient data for older women. False-positive results are common in all age groups and lead to additional imaging and biopsies. Women age 40-49 years experience the highest rate of additional imaging whereas their biopsy rate is lower than older women. Mammography screening at any age is a tradeoff of a continuum of benefits and harms. The ages at which this tradeoff becomes acceptable to individuals and to society are not clearly resolved by available evidence.” (page 25)
If the data was insufficient for older women, why did the panel set an upper age limit? (The 2002 recommendation did not have this.) If mammography screening indicates benefits for all age groups, why recommend that women in their 40s not receive mammograms? Perhaps the answers can be found in “Appendix C1. Contextual Question: What is the cost-effectiveness of screening?”
“Overall results showed that screening mammography operates at a loss, and payer reimbursement was not sufficient to cover overhead costs.” (p 86)
“Biennial CBE [clinical breast exam] combine with mammography had a higher cost-effectiveness ration compared with annual CBE combine with mammography....” (p 87)
Third, there really isn’t that much controversy on the issue. Refer to Table 1 on page 35 and you will find that only the ACPM and the World Health Organization advise beginning mammograms at age 50.
Finally and unfortunately, you are wrong that the USPSTF’s newly revised guidelines will not affect insurance coverage. Please refer to page 17 of the Patient Protection and Affordable Care Act (a.k.a. the Senate Healthcare bill). Beginning on line 7: “In general- A group health plan and a health insurance issuer offering group or individual health insurance coverage shall provide coverage for and shall not impose any cost sharing requirements for- evidence-based items or services that have in effect a rating of ‘A’ or ‘B’ in the current recommendations of the United States Preventive Services Task Force;”
The USPSTF’s new guideline (“biennial screening mammography for women aged 50 to 74 years") has a “B” rating. It certainly appears that the government will be dictating what insurers can cover.
(I could go into a little "fear-mongering" at this point considering the USPSTF is a panel and if their recommendation that women in their 40s not receive routine mammograms were to be enforced, deaths would result, but that would just get people upset at me for suggesting such an outrageous thing.)

Michelle of UT 2:40AM November 22, 2009

Years back I read a Lancet report on the many xray screenings that US women were subjected to. The report commented that the screenings did detect cancers and save lives, but it also said the number of cancers CAUSED by those screenings was unknown.
I told my doctor that, since I had no cancer deaths that I knew of in my family, I would forgo breast cancer screenings by xray. He agreed with my choice. It is the one question that I brought up with every doctor who I interviewed before becoming his patient.
A comment was made several times that equipment is expensive and hospitals and facilities must recoup expenditures on these machines and so encourage doctors to order many tests.
The article that I read also mentioned that a woman, if she must get these tests, should at least enquire of the numer of RADs of radiation the machine at her facility puts out. The newer the machine, the less radiation you are exposed to. Hospitals (teaching) usually have the most up to date equipment. Private screening facilities and mobile units, though less expensive, often are using the old and more dangerous machines which are purchased off of hospitals as they update their equipment.
In the US everything is business. Some patients are getting cancers from our medical facilities desire to save a buck. So long as the patient cannot prove causation between any specific procedure and her cancer there is no downside and every upside to encouraging a woman to get frequent xray screenings.
Oh, and there are more and more US doctors and European facilities warning of the health risks of too many mammograms.
When I was a kid my dentist, following the dictates of his profession at the time and being the then 'state of the art', xrayed patients at nearly every visit. He later died of cancer, as did many of those old dentists.
I think the medical profession released this info because pretty soon the public will call them for the frauds that they are. A national health care system will not allow unnecessary procedures to be done for the simple purpose of recouping investment costs. A good doctor shoud not be duping patients into taking tests which are potentially harmful.

Joan Dalton of AL 10:24AM November 18, 2009

One of those non-existant Death panels that the Democrats say don't exist!

Jeff of WI 10:10PM November 17, 2009

So we're supposed to trust this "government independent panel"? Did this panel include an oncologist??
Even if it did, this timing is highly suspicious -- as we've been told for years that mammogram screening should start in our 40s -- and now this while the Democrats pushing the "public option" & health care "reform" are threatening to "cut costs," gut Medicare by some $500 billion, & effectively lead us down the road to health care rationing.
I'm so angry at this steam is coming out of ears. Needless to say, I will not be voting for any politician of either party that supports any form of Obama, Pelosi or Baucus-care!

SheilaJ. of OH 7:34PM November 17, 2009

In these days of stupid, crazy, hurtful, just awful, ideas this has to be the winner. No mastter what the real reason for this, and it has to be obscure, it really smacks of saving money by someone. If Medicare comes up with this as one of it's SAVERS, I will have to think about resigning from mankind.
I am 80 years old and have seen more healing of breast cancers than my generation could even imaginewhen we were young. What diffeence does it make whether you save a life at 40 or 50 ot sixty or seventy or eighty. Itis the life of someone precious to someone. And isn't that wonderul. The H--- with the small amount of anxioety caused by a false positive. The H--- with the anxiety caused by a removal of a node. The joy of not hving cancer or getting it in time has to be tremendous. It has to be the goal of every known cancer. Early detection and survival for the patient.
PLEASE will somone on these committees in Washington find some common sense. Or maybe better talk to someone my age who an tell them what it used to be like. Still is as a matter of fact, if not found in time. There isnothing fine or great about cancer. Don't keep what little we have gained to satisfy a bunch of idiots.

Mrs. Austin S. Callaway of SC 5:15PM November 17, 2009

This is Katherine Hobson: Remember that the USPSTF is not telling you not to get a mammogram in your 40s. The task force is saying it should not be a blanket recommendation. Talk to your doc about your individual risk. If cancer runs in your family, you are not at average risk and a mammogram is more likely to be helpful to you. If you have no risk factors and decide the risks outweigh the benefits for you, you may decide not to get a mammogram. Another woman in the same position may opt to get one. Everyone knows someone who was diagnosed with breast cancer in her 40s with a mammogram. The question is not whether that mammogram found the breast cancer, but whether it helped or will help her live longer. That happens in some cases. It does not happen in other cases, unfortunately, which is why there is so much controversy about screening in this age bracket. But again, the USPSTF is by no means saying no woman in her 40s should be screened, but that it should be an individual's choice based on her own preferences and risks.

Katherine Hobson of NY 5:13PM November 17, 2009

This is the public option & Obamacare folks: push back the age for mammograms for the good of the collective.
Don't get mad, take action.
Start calling your senators NOW to not let this travesty pass.

Stacy of OH 5:02PM November 17, 2009

You know if we already had this type of thinking in place I would probably be dead right now!!! Because I would not have gotten that mammogram at my age right now, which is 45 and the Breast Cancer that I NOW HAVE would have not been detected until it WAS TOO LATE!!!!!! That is all I am going to say about this subject, it is making me sick to think about it!!!!

Patricia Cheek of NC 4:36PM November 17, 2009

I just had my 32nd annual Mammogram,and discovered something I hadn't known before; that my Cinic was charging Medicare $445 for this Mammogram.
I think that the bottom line here is saving money, and that's very admirable. More people will fall in love with the Health Care Plan now being debated if the Health Care policymakers can point to a Diagnostic Test that will save money if not performed so often. Perhaps, but I am more concerned with saving lives, and a lot more clinical and longitudinal clincal studies in particular, need to be done before this Fiat - from what I can see.

Clemmie Morton of IA 4:25PM November 17, 2009

My youngest sister had a mammogram at the age of 38 after discovering a lump in her breast.
She called her doctor and did a mammogram and found a small lump which was cancerous.
She is now a 5 year survivor and cancer free.
To hell with these new guidelines.
If cancer runs in your family, like my family, get that mammogram.
Charles Muller Jr
Bronx NY

Charlie Muller Jr. of NY 4:12PM November 17, 2009