Weighing In on the Mammogram Controversy

A federal advisory panel said recently that only women between the ages of 50 and 74 need to have routine mammograms. They went on further to say that routine mammograms for women in their forties could actually present more harm than good. Their argument stems from evidence that approximately 10 percent of mammograms show false positive results, which contributes to the need for further testing, biopsies, and acute anxiety in a large number of women.

This change in position is in stark contrast to what the American Cancer Society has recommended and from what has become conventional wisdom to women for decades. The new findings were issued by the U.S. Preventative Services Task Force, whose recommendations influence the coverage of mammograms in the Medicare system and several insurance companies.

Critics of this new stance say that the new guidelines are simply a symptom of the governments desperate need to cut costs in the US health care system. It is true that there are a large number of false positives, which leads to the need for additional testing, and this of course, leads to additional burden on insurance companies and Medicare. However, when we remember that according to American Cancer Society, breast cancer is the most common killer of women next to lung cancer, the decision to cut benefits for early detection seems to lose its steam under the pressure of pure statistics. If breast cancer is such a major culprit in fatal diseases for women, why would the citizens of the United States support this change in policy?

Then, of course, there is the issue raised that those who can afford the $200 - $300 per mammogram will be able to take steps for early detection of breast cancer, while the poor will be less likely to get it done. Also, mammogram technology has taken strides with the advent of new digital methods that are easier for women, quicker, and less costly. The new technology coupled with the conventional wisdom that women should get routinely checked beginning in their forties has created several opportunities in the field of radiology in the service of prevention.

The issue is not one that will go away quickly; it is sure to be one that will mount great pressure given the long standing recommendations from radiologists, researchers, and the countless testimonials from women all over the country about how early detection saved their lives.

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