For Health or Money: The Motivation Behind New Mammogram Guidelines

Women and health care professionals are confused and outraged by the mammogram guidelines released by the United States Preventive Services Task Force (USPSTF) on Monday, denouncing the task force for prioritizing economy over health.

Regular mammogram screenings have accounted for a 15 percent decrease in the rate of breast cancer. The new guidelines suggest that women start going for regular mammograms at 50 -- ten years later than previously recommended -- and get checked every other year, instead of annually, unless they are at high risk. Critics, such as the American Cancer Society, worry that fewer mammograms will mean a rise in undetected breast cancer, potentially costing women their lives.

Opponents are also concerned that insurance companies will use this as an excuse to refuse to cover mammograms for women under 50. The National Committee for Quality Assurance, a non-profit that grades insurance companies, has already altered its evaluations to reflect the change.

The task force claims that the issue at stake is unnecessary screening and treatment. Women in their forties are 60 percent more likely than older women to have false-positive mammograms; according to Dr. Diana Petitti, vice-chair, this leads to needless medical procedures, such as biopsies, accompanied by high stress. The USPSTF says that the relatively small number of women whose cancer is detected -- only one cancer death is prevented for every 1,904 women screened from age 40 to 49 -- is not worth the anxiety of all those false-positives.

Perhaps that makes sense ... unless, of course, you happen to be one of those women it would save. What really bothers me here is that the new guidelines seem to be based on the idea that we need to save this country's women from anxiety, rather than substantial medical evidence. It strikes me as harking back to the Victorian era, when medical professionals' number one diagnosis for female patients was hysteria -- an anxiety disorder that, it turned out, doesn't exist.

Why not recommend an increase in education and preparation -- including the realities of false-positives -- rather than a decrease in screening? I imagine prostate exams are no picnic for men, so should we spare them the stress and reduce screening for prostate exams, or do we assume they can handle it because they're men? When it comes to matters of life and death, I think women can handle a little stress.

Photo Credit: Buddhini Ekanayake