HHS Secretary Says Never Mind Those New Breast Cancer Screening Guidelines Made By an HHS Advisory Panel
November 19, 2009 - 7:46 AMAmid an outcry from confused, angry women and physicians, HHS Secretary Kathleen Sebelius issued a statement Wednesday basically telling women to ignore what a government advisory panel (appointed by Sebelius' own agency) said this week about breast cancer screening.
Amid an outcry from confused, angry women and physicians -- even the American Cancer Society objected to the changes -- Sebelius issued a statement Wednesday basically telling women to ignore what the U.S. Preventive Services Task Force had said. The USPSTF advises HHS, and its members are appointed by HHS.
“There is no question that the U.S. Preventive Services Task Force Recommendations have caused a great deal of confusion and worry among women and their families across this country," Sebelius said on Wednesday. She said she wanted to address that confusion "head-on."
"The U.S. Preventive Task Force is an outside independent panel of doctors and scientists who make recommendations. They do not set federal policy and they don’t determine what services are covered by the federal government.
“There has been debate in this country for years about the age at which routine screening mammograms should begin, and how often they should be given. The Task Force has presented some new evidence for consideration, but our policies remain unchanged. Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action," Sebelius said.
On Monday, Nov. 16, USPSTF announced that was changing long-standing mammography guidelines and would no longer recommend routine, annual mammograms for women between the ages of 40 and 49.
"The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account,” the USPSTF said.
The task force did recommend biennial (every two years) mammograms for women aged 50-74. And it recommended "against teaching breast self-examination."
Some Republicans have seized on the changing guidelines as an example of how government cannot be trusted to run health care. A number of women and physicians have expressed dismay in media interviews, saying they view the USPSTF’s new guidelines as a form of health care rationing that puts financial considerations above lives.
“My message to women is simple,” Sebelius said on Wednesday. “Mammograms have always been an important life-saving tool in the fight against breast cancer and they still are today.”
Sebelius told women to “[k]eep doing what you have been doing for years -- talk to your doctor about your individual history, ask questions, and make the decision that is right for you.”
The American Cancer Society also is urging women to continue getting annual mammograms beginning at age 40. “Our experts make this recommendation having reviewed virtually all the same data reviewed by the USPSTF, but also additional data that the USPSTF did not consider," the American Cancer Society said on its Web site.
The American Cancer Society also said it agreed with USPSTF on the limitations of mammography in younger women: "Some women who are screened will have false alarms; some cancers will be missed; and some women will undergo unnecessary treatment…These limitations are somewhat greater in women in their forties compared with women in their fifties, and somewhat greater in women in their fifties compared with women in their sixties."
Nevertheless, the ACS said those limitations "do not change the fact that breast cancer screening using mammography starting at age 40 saves lives."
According to the ACS, the most recent data show us that approximately 17 percent of breast cancer deaths occurred in women who were diagnosed in their 40s, and 22 percent occurred in women diagnosed in their 50s.
Last month, HHS Secretary Sebelius released a report touting the benefits of "health insurance reform" for women with breast cancer.
In her Oct. 23 statement, Sebelius said, "We are fighting for health reform that will help improve treatment for women with breast cancer and doing all we can to encourage women to take the simple steps that can help prevent this disease.”
Breast cancer will affect one in eight American women during their lifetime, Sebelius said. The report noted the high cost of treatment, saying that even breast cancer patients with employer-based insurance had total out-of-pocket costs averaging $6,250 in 2007.
“Today, breast cancer patients incur thousands of dollars in debt, and breast cancer survivors struggle to get the affordable care they need,” Sebelius said last month. “Health insurance reform will bring costs down, make care more affordable and prevent insurance companies from discriminating against breast cancer survivors.”