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USPSTF Mammography Recommendations Should Be Specifically Excluded From Health Care Reform Legislation
Date:11/24/2009

ual screening mammography starting at age 40

  • It is well known that mammography has reduced the breast cancer death rate in the United States by 30 percent since 1990 - hardly a small benefit.
  • Based on data on the performance of screening mammography as it is currently practiced in the United States, one invasive cancer is found for every 556 mammograms performed in women in their 40s.
  • Mammography only every other year in women 50-74 would miss 19 to 33 percent of cancers that could be detected by annual screening.
  • Starting at age 50 would sacrifice 33 years of life per 1,000 women screened that could have been saved had screening started at age 40.
  • Eighty-five percent of all abnormal mammograms require only additional images to clarify whether cancer may be present (or not). Only 2 percent of women who receive screening mammograms eventually require biopsy. The USPSTF data showed that the rate of biopsy is actually lower among younger women.

The issue of overdiagnosis is controversial. By the Task Force's own admission, it is difficult to quantify and is less of a factor among younger women who have many years of life expectancy. Weighing the significant, documented benefits of annual mammography screening against possible anxiety and need for additional imaging or biopsy, it is difficult to understand how the USPSTF reached its recommendations.

"These new recommendations have created a great deal of confusion among American women - a situation that might have been avoided by consulting those of us in the field who actually care for women who are seeking detection, diagnosis, and treatment of breast cancer. The unfortunate result may be decreased utilization of this life-saving tool. I urge insurers and Congress not to compound the problem by allowing the possibility of denying coverage to women who seek routine annual mammography starting at age 40 and continuing for as long as they
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4. Breaking Through the Mammography Controversy
5. Task Force Member Defends Mammography Guidelines
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