The Register-Herald, Beckley, West Virginia

Editorials

November 23, 2009

Bad idea

New mammogram guidelines could cost untold number of lives

There are two words that strike fear into the heart of every woman: breast cancer. Add “you have” in front of them, and that fear can quickly morph into panic and sheer terror.

We’ve come a long way in the detection and treatment of breast cancer over the course of the last few decades, thanks, in part, to clearly understood guidelines for finding tumors in their early stages when they can be more successfully treated.

The American Cancer Society and most doctors have told women to begin self exam in their 20s and start having regular mammograms at age 40 and continue to have them annually for as long as they are in good health.

Only God knows how many lives have been saved as a result of this advice.

Then the feds decided to upset the apple cart.

Last week, the U.S. Preventive Services Task Force said most women do not need their first mammogram until age 50 and shouldrepeat it every two years. Some area doctors called the new recommendations “crazy” and “irresponsible.”

We have to agree.

Beckley surgeon Dr. Scott Kilmer told The Register-Herald that about 35 percent of the patients he treats for breast cancer are in their 40s and about half find their cancer through mammograms.

At this point, most groups who deal with making recommendations for mammograms are sticking with the older guidelines. But what if those made by the Preventive Services Task Force become the norm? How many will die that could have been saved?

Because the task force influences coverage of Medicare screening tests and many insurance companies, some doctors have suggested this may be a back door way to limit costs.

Whatever the reasons for the Preventive Services Task Force’s deviation from the long-term norm, it has set the medical community on its ear.

While health care costs are spiraling out of control and some tests may be ordered simply as protection against later litigation, the link between early mammograms and breast cancer survival rates is too strong to be ignored.

The “first at 40” criteria should not be changed and coverage for mammograms should be stepped up, not cut back.

It is our hope that the notion of waiting until 50 soon fades.

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