Wednesday, November 18, 2009

Mammograms and the Swift Boat?

I think most of us were surprised to learn of the U.S. Preventive Task Force's recommendations that routine breast cancer screenings be postponed until age 50, barring identifiable risks. Conventional wisdom has long held that such screenings begin at age 40. I've been struck by the heated response from within the medical profession, most especially by MGH's Dr. Daniel Kopans, a noted radiologist and cancer expert. According to The Boston Globe (11-17-09), Dr. Kopans said that these new guidelines: "will condemn women ages 40-49 to unnecessary deaths from breast cancer." Strong words.

I heard Dr. Kopans speak on WTKK this morning and learned that most (70%+) of newly discovered cancers come in patients with no prior "identifiable risks". So, those women without such risks, i.e., family history, are not recommended for screenings until age 50, which could be too late. On NPR, Rachel Zimmerman of WBUR's Commonhealth blog) spoke of personal experience and a decision that points out that although guidelines such as the ones promulgated by the Preventive Task Force are necessary and appropriate, when the decision is personal, it's easy to justify ignoring them. See Rachel's piece by clicking here.

I was fascinated by some of the comments on the radio after Dr. Kopans departed. One caller stated that the new guidelines will be utilized by managed care and other payers as justification for not covering mammograms before age 50. Another noted that this is what we can expect from a "government takeover" of health care, a la the public option. An interesting and unsettling discussion ensued regarding the Federal Government's possible heavy handed role in the new health care system.

This may have been an isolated and narrow view expressed by only a few during a drive time radio program. Or... the proposed new mammogram guidelines could inadvertently become a banner for health reform opponents to wave in the coming weeks. Swift boat anyone?


  1. My first thought when hearing the news that these guidelines represent the most significant threat to passage of health care legislation. If the issue continues to generate news, more and more people are going to associate these guidelines with what the world will be like under Obamacare. And you know what, I'm beginning to wonder a bit too. Whether it will be Obamacare or not, I have a hard time believing the insurance companies will not leap on this validation of not paying for services. I've heard that those who are relatively happy with their health coverage are going to be the most unhappy if and when health reform passes. I'm beginning to wonder if that argument has juice.

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