Cancer screening guidelines bring disagreements

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According to the National Breast Cancer Foundation website, http://www.nationalbreastcancer.org, it is estimated that more than 200,000 women will be diagnosed with breast cancer this year and more than 40,000 will die. Out of those 40,000 women, most are likely to be African-American women.

The National Women’s Health Information Center of the United States Department of Health and Human Services Office on Women’s Health website, http://www.womenshealth.gov, says African-American women are more likely to die from breast cancer because tumors are found later and in more advanced stages, so there are fewer treatment options.

HelpingTheFight
HELPING THE FIGHT— Participants from the 2009 Susan G. Komen Pittsburgh Race for the Cure. The race raises funds to fight breast cancer.

With information like this, it is easy to see why some find the suggested breast cancer guideline recommendations released by the U.S. Preventive Services Task Force, a little alarming.

In November, the U.S. Preventive Services Task Force of the U.S. Department of Health and Human Services, an independent panel of experts that reviews the evidence of effectiveness and develops recommendations for preventive services, released recommendations for breast cancer screening guidelines that suggests women should no longer get routine mammograms until age 50 and should get them every other year, instead of every year.

No representative from the Department of the Health & Human Services responded to the Courier’s attempt to contact them as to why they made these recommendations, prior to press time.

“We were surprised by the guidelines, like many others, but we are not recommending a change in the current guidelines,” said Kathy Purcell, executive director of the Pittsburgh Affiliate of the Susan G. Komen for the Cure. “We will continue to promote annual mammograms for women age 40 and older and for women with an average risk and even earlier for women with a greater risk.”

Dr. Steven Evans, a clinical associate professor of surgery, UPMC Pittsburgh Physicians Department of Oncology and a member of the Gateway Medical Society agreed with Purcell and said, “Several panels make consensus statements, but they are not the prevailing body. My recommendation is that women need to remain proactive in holding discussions with their doctors and have a high risk need to continue to get regular mammograms. Start at the age of 30 and get regular ones at 40. I will continue to tell my patients to do these things.”

When it comes to breast cancer, early detection is the greatest weapon toward a successful fight against the disease. “We (as physicians) would be negligent in not telling them to get tested. We have to do what’s right. A patient’s life comes first,” Evans said. “Mammograms do still save lives and early detection is important.”

Purcell said one of the organization’s concerns is that these guidelines will be a setback in the progress that has been made so far when it comes to breast health, education and testing. “We are afraid women will listen to these guidelines. We see we’ve made great strides in lowering the mortality rate through early detection. We know that early detection is what saves lives.”

With access to health care already a struggle for many African-Americans, some wonder if the suggested guidelines will be used by HMOs to lessen their coverage of mammograms. Mammograms can cost an estimated $200 or more without insurance.

Evans said there is a concern that mammogram reimbursement will go down, but that there are still non-profit organizations that continue to support mammogram voucher programs.

The Susan G. Komen for the Cure Pittsburgh Affiliate along with Adagio Health, which works with uninsured and medically underinsured women to provide free mammograms and follow-up diagnostic services through their Mammogram Voucher Program. The program provides screening mammograms, diagnostic mammogram, breast sonograms, clinical examination of the breasts, needle aspirations and biopsies and surgical consultations. In order to get free mammograms, women must meet their specified requirements.

Out of all the confusion, Purcell said the one good thing that has come from the task force’s recommendations is that it has brought attention to the fact that there is a need for better screening tools. Mammograms are not always the most efficient method, but until better ones are developed, women should still get annual mammograms and continue with self-breast exams.

(For more information on the voucher program, visit http://www.mammogramvoucher.org.)

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