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Government Task Force Changes Breast Cancer Screening Recommendations

Britain's NHS, as all government run health care systems, continuously struggles financially, which means that it, like all government run health care systems, is always looking for ways to save money. One of the strategies it employs is to postpone at what age it will cover certain procedures or tests for its citizens. For example, the NHS pushed back when it will cover a woman's cervical cancer screenings from the age of 20 to 25. Even after women reach the age of 25, they can only get the test every 3-5 years, instead of every year, which is the recommendation here in America. Considering how sexually active young women are these days, you can only imagine how dangerous this is.

Here in the States, the U.S. Preventive Services Task Force has been advising women age 40 and over to get mammograms to screen for breast cancer every two years. The American Cancer Society and the American College of Radiology recommend women get mammograms every year.

However, in a sudden reversal, the US Preventative Services Task Force now says women between 40-49 should not get mammograms at all and women 50 and over should only get them every other year. On top of that, women over the age of 74 shouldn't get any screenings at all, mammography or otherwise:

In its first reevaluation of breast cancer screening since 2002, the independent government-appointed panel recommended the changes, citing evidence that the potential harm to women having annual exams beginning at age 40 outweighs the benefit.

Coming amid a highly charged national debate over health-care reform and simmering suspicions about the possibility of rationing medical services, the recommendations immediately became enveloped in controversy.

"We're not saying women shouldn't get screened. Screening does saves lives," said Diana B. Petitti, vice chairman of the U.S. Preventive Services Task Force, which released the recommendations Monday in a paper being published in Tuesday's Annals of Internal Medicine. "But we are recommending against routine screening. There are important and serious negatives or harms that need to be considered carefully."

As expected, this has created quite a bit of controversy:

But the American Cancer Society, the American College of Radiology and other experts condemned the change, saying the benefits of routine mammography have been clearly demonstrated and play a key role in reducing the number of mastectomies and the death toll from one of the most common cancers.

"Tens of thousands of lives are being saved by mammography screening, and these idiots want to do away with it," said Daniel B. Kopans, a radiology professor at Harvard Medical School. "It's crazy -- unethical, really."

The Susan G. Koman foundation issued a press release that said mammography is by far the best screening method, and until a better one is developed the current recommendations for breast cancer screening should not change.

ObamaCare hasn't even passed the Senate yet, and already this task force seems to be implementing cost cutting measures in anticipation of the government's increased financial stake in the health care of millions of Americans. And if this doesn't concern you, keep in mind that Pelosi's health care bill that just passed the House is chock full of new government health care task forces that will issue all manner of new recommendations, the vast majority of which will probably be that citizens should postpone screenings for various cancers, illnesses, and disorders.

And President Obama said no one should come between you and your doctor. What he meant is that no one should come between you and your doctor - except a government health care task force.


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Comments (24)

It's the first, distant sou... (Below threshold)
Jim Addison:

It's the first, distant sound of gunfire in the approaching cost wars.

No "death panels" here - just Boards of Bureaucratic Efficiency to watch the expenses. No need to worry about them pulling the plug on Grandma, because at her age and health they will never let her be plugged in.

Remember that even the current horrible financial forecasts of ObamaCare's costs include a supposed future $500 billion savings on Medicare - how many Grannies have to get kicked to the curb with a pain pill to make up that kind of money?

Let the rationing begin....... (Below threshold)

Let the rationing begin.....

It is also interesting that... (Below threshold)
Sabba Hillel:

It is also interesting that the board that made the decision does not have any oncologists on it. Apparently, they are a group of Obama "white jackets"



Current members of the Task Force are listed below. They have recognized expertise in prevention, evidence-based medicine, and primary care.

Bruce N. Calonge, M.D., M.P.H. (Chair)
Chief Medical Officer and State Epidemiologist
Colorado Department of Public Health and Environment, Denver, CO

Diana B. Petitti, M.D., M.P.H. (Vice Chair)
Professor of Biomedical Informatics
Fulton School of Engineering
Arizona State University, Tempe, AZ

Susan Curry, Ph.D.
Dean, College of Public Health
Distinguished Professor
University of Iowa, Iowa City, IA

Allen J. Dietrich, M.D.
Professor, Community and Family Medicine
Dartmouth Medical School, Hanover, NH

Thomas G. DeWitt, M.D.
Carl Weihl Professor of Pediatrics
Director of the Division of General and Community Pediatrics
Department of Pediatrics, Children's Hospital Medical Center, Cincinnati, OH

Kimberly D. Gregory, M.D., M.P.H.
Director, Maternal-Fetal Medicine and Women's Health Services Research
Cedars-Sinai Medical Center, Los Angeles, CA

David Grossman, M.D., M.P.H.
Medical Director, Preventive Care and Senior Investigator, Center for Health Studies, Group Health Cooperative
Professor of Health Services and Adjunct Professor of Pediatrics
University of Washington, Seattle, WA

George Isham, M.D., M.S.
Medical Director and Chief Health Officer
HealthPartners, Minneapolis, MN

Michael L. LeFevre, M.D., M.S.P.H.
Professor, Department of Family and Community Medicine
University of Missouri School of Medicine, Columbia, MO

Rosanne Leipzig, M.D., Ph.D
Professor, Geriatrics and Adult Development, Medicine, Health Policy
Mount Sinai School of Medicine, New York, NY

Lucy N. Marion, Ph.D., R.N.
Dean and Professor, School of Nursing
Medical College of Georgia, Augusta, GA

Joy Melnikow, M.D., M.P.H.
Professor, Department of Family and Community Medicine
Associate Director, Center for Healthcare Policy and Research
University of California Davis, Sacramento, CA

Bernadette Melnyk, Ph.D., R.N., C.P.N.P./N.P.P.
Dean and Distinguished Foundation Professor in Nursing
College of Nursing & Healthcare Innovation
Arizona State University, Phoenix, AZ

Wanda Nicholson, M.D., M.P.H., M.B.A.
Associate Professor
Johns Hopkins School of Medicine and Bloomberg School of Public Health, Baltimore, MD

J. Sanford (Sandy) Schwartz, M.D.
Leon Hess Professor of Medicine, Health Management, and Economics
University of Pennsylvania School of Medicine and Wharton School, Philadelphia, PA

Timothy Wilt, M.D., M.P.H.
Professor, Department of Medicine, Minneapolis VA Medical Center
University of Minnesota, Minneapolis, MN

I think the rationing has a... (Below threshold)

I think the rationing has already begun. I had to go to the ER due to an allergic reaction. The bill came to $960.39. Medicare paid $5.40. Yes, Five dollars and forty cents. I had to pay the rest in order to keep a good credit rating. I am retired, on a fixed income. That took away almost all of my savings. The ER visit was not for sniffles, or an earache. It was life-threatening. Can you imagine with the health care that obama wants to force on us, if they are trying to squeeze $550B from Medicare, how little they will pay in the future? I am so disappointed and irritated at our current admin. Bet if Fancy pants nancy needs an er visit, she will be treated like a queen on my dime. What a farce!

A few points to consider be... (Below threshold)
Mary E.:

A few points to consider before flying off the handle on this one:

1. Viewed strictly from a dollars and cents point of view, looking at just the cost/benefit ratio, this recommendation is correct. Mind you, that is looking at this solely from a cost reduction frame of mind.

2. Welcome to how liberals think - with their emotions. I have the same gut reaction to this as most women do - What!? The health of my breasts is above all cost considerations! I DEMAND the very best of care and I don't care what it costs! Difference is, I would be willing to pay those costs.

3. This is just a recommendation. No one is going to tell you that you cannot have a mammogram before age 50, or more often than every other year. You just might have to pay for it yourself, out of your own pocket. What the recommendation would do is give insurance companies (IF we are not saddled with Obama or Pelosi-care) the opportunity to adjust coverage and benefits for mammography to coincide with these new parameters.

Unlike liberals, we know that we shouldn't expect to get everything free, right? Again, you would not be prevented from getting mammograms, only getting insurance coverage for them the same as we have it now.

Those who would most likely be affected adversely from this are women from lower socio-economic classes. Those are also the women who are at higher risk of breast cancer, with earlier pregnancies, higher rates of smoking, poor nutrition, less likely to breastfeed their babies into toddlerhood if at all.

Getting a clearer picture of how this works now?

But yes, this is what healthcare rationing will be like. It will come masquerading in as new recommendations such as this with the aim of reducing healthcare costs. But as it stands now, we would still have the option to pay for the medical tests and care that we and our doctors seem necessary, if we are able to. With Obamacare, not so much ... enjoy your freedom while you can.

Obviously this is the first... (Below threshold)
Sandra Bernhoft:

Obviously this is the first step in rationing, so it will already be in place by the time Obama's health "reform" begins. "Something wicked this way comes." Americans who can't seem to get their heads out of the sand, need to come up for air, and recognize all the deceitful language for what it is, and protest the downright lies from this administrations and its congressional lackies. I'll just bet most of the people named above where at the White House for the doctors' photo op meeting.

It appears that most, if no... (Below threshold)

It appears that most, if not all, members of the panel have been on it for several years. IE, they weren't appointed by the current administration. Here's a roster from August 2008:


As to the point about "no oncologists" This panel makes *recommendations* on just about everything medically related:


I lost my mother to breast ... (Below threshold)

I lost my mother to breast ca which she was diagnosed in her forties.She might have lived if it had been diagnosed earlier. My sister just skipped over the fifty mark before she was diagnosed with it. A good friend of mine also lost her mother to breast ca in her late forties. Having worked in the medical field (radiology) the last 17yrs,I have seen a lot of young women with breast ca. This whole thing seems pretty weird to me.

I don't think the current NHS that England has was the one envisioned when it was implemented. I doubt the Canadians planned for theirs to be where it is either. I think the liberals should really understand this when they promote healthcare reform here in the US. Our kids and grandkids will be doing more than just paying for it..they will be living with it.

Jim Addison #1I agre... (Below threshold)
Eneils Bailey:

Jim Addison #1
I agree with you.
A "death panel" by any other name is still a "death panel."
I think politicians who support government health care are into a very sinister scheme to lower health care cost at the expense of the ladies. But you may add that these cost will not be covered till 2012 or 2014 under government health care., why the rush? The supporters of GHC need a good score of their bill from the CBO.
And also, the last numbers for dollars spent on health care indicated the ladies consume about 70 per cent of every HC dollar spent. Want to cut costs, go to where the most money is spent.
As time passes, I think we will see more of this. Groups, under the influence of politician, will be telling us we do not need all those doctor visits and preventative medicine that we once thought. This will have more of adverse effect on females and/or old people that any other identifiable group.
Remembrer, a "deat panel" by any other name......

So on top of everything els... (Below threshold)

So on top of everything else, we have to worry about the breast panels.

I'm sure little Stevie Gree... (Below threshold)

I'm sure little Stevie Green can find a silver lining in all this. Like: "Maybe if those woman die younger, Social Security will remain solvent longer."

I hope these revisions are ... (Below threshold)

I hope these revisions are a step in the right direction.

Folks, this set of recommen... (Below threshold)

Folks, this set of recommendations is based on evidence-based research. If you are HIGH RISK you follow a different screening schedule. Find something else to pick on. This approach will save WASTED money.

Personally, I think that considering how cheap mammography has now become (it depends where you go, but you can get a decent screening procedure for less than a bag of WalMart groceries) we don't need insurance pools to pay for it.

Insurance should be paying for extraordinary costs, not routine maintenance. If you are REALLY dirt poor, then societal support for your maintenance should be based on evidence-based research, not emotional and self-serving constructs.

Folks, In my humble opinion... (Below threshold)

Folks, In my humble opinion this administration is totally out of control. It's too bad so many people are so naive that they really don't see what is happening right before their eyes. A lot of them come from the thought that our Government should take care of everyone!

Folks let me tell you this is a very serious matter especially if you like your freedom or at least what is left of it!

Epador what your recommenda... (Below threshold)
Iowaright wife:

Epador what your recommendation does is basically make it possible for the very rich and those that continuosly live off "societal support" to be able to get the screening, but the middle class who actually pay the "societal support" would have to choose between the bag of groceries or the mammogram.

Insurance should be paying ... (Below threshold)

Insurance should be paying for extraordinary costs, not routine maintenance.
13. Posted by epador

What happened to free health care?

What happened to free he... (Below threshold)

What happened to free health care?

Take one Government Issue aspirin, and call for an appointment next year.

That phone call will be ans... (Below threshold)

That phone call will be answered by a call center in India!

The USPSTF is not a governm... (Below threshold)

The USPSTF is not a government agency. It's is an independent task force that receives federal money. One of the docs on-board works for Blue Cross and Blue Shield (as an "advisor") and none of the physicians are oncologists.

Ask yourself who benefits the most by denying early detection: Insurance companies. They don't want reform and they certainly do not want Obama's health care plan.

Sorry, Mojopo, but how do i... (Below threshold)
Jim Addison:

Sorry, Mojopo, but how do insurance companies "benefit the most from denying early detection?"

They would rather pay the higher costs of treatment for later detection?

"They would rather pay t... (Below threshold)
Victory is Ours:

"They would rather pay the higher costs of treatment for later detection?"

Careful, Jim. If you use logic heads will explode.


So it appears that Sarah Pa... (Below threshold)

So it appears that Sarah Palin was right when she talked about Death Panels, and the obama admin went ballistic. They were P*SSED she caught on so soon. Typical liberal crap being shoved down our throats, and I personally don't care for the taste.

re:15Stop and thin... (Below threshold)


Stop and think this one through. You want to pay for your own way, or your way AND a bunch of other people's?


Your freedom to waste our tax money, or our freedom to keep our money?

Most oncologists don't perform cancer screening, primary care providers do. Most medical oncologists make their money by giving folks chemotherapy, radiation oncologists by treating people with radiation, surgical oncologist by surgery. No matter how you look at this, that gives them a significant bias towards treating people. There are plenty of less than scrupulous oncologists who favor making money, supporting "standards of care" that support them making money. The same can be said for imaging professionals who make money reading mammograms and ultrasounds of the breast, and so on.

Are you folks saying that you want the foxes guarding the hen house?

Epador -Are you sa... (Below threshold)

Epador -

Are you saying we're at 'damned if we do, damned if we don't' levels of health care coverage?






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