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11/19/2009 09:50 AM Posted by: Dr. H. Alejandro Preti

HHS Secretary downplays new mammography guidelines.


Two days after the US Preventive Services Task Force relaxed recommendations concerning yearly mammograms, HHS Secretary Kathleen Sebelius issued a statement saying that federal policy remains unchanged despite the recommendations. ABC World News (11/18, lead story, 2:45, Gibson) reported on "more fallout [Wednesday] concerning the recommendations from that government advisory task force on the frequency of mammograms. Yesterday, as we reported, doctors were distancing themselves from the recommendations. Today, it was the government." Sebelius said that "middle-aged women should keep doing what they're doing, getting yearly testing. But some doctors are telling us that women are actually canceling treatments, citing the new recommendations."

        The CBS Evening News (11/18, lead story, 2:00, Couric) reported, "The confusion just keeps growing over those new guidelines for breast cancer screening. A federal panel," the US Preventive Services Task Force, "said most women should start getting routine mammograms at age 50, not 40. But many doctors and the American Cancer Society disagree, and today the Secretary of Health and Human Services added to the controversy when she seemed to keep her distance from the new recommendations."

        NBC Nightly News (11/18, lead story, 2:20, Curry) also led its newscast with the "sudden and surprising development in a story we've been bringing you this week." NBC's chief medical editor, Dr. Nancy Snyderman, added, "Many are asking why Secretary Sebelius came out with this statement today, and after all the backlash from advocacy groups, women, and their doctors whether today's statement puts politics before science."

        In a front-page story, the New York Times (11/19, A1, Sack, Kolata) reports that the White House "emphasized" that the guidelines "were not binding on either physicians or insurers. Administration officials also fired back against Republicans who argued that the recommendations illustrated the dangers of an expanded government role in medical decision making."

        The AP (11/19, Schmid) adds that Sebelius said that the task force does "not set federal policy and they don't determine what services are covered by the federal government."

        Still, In Time (11/19, Park), Dr. George Sledge, president-elect of the American Society of Clinical Oncology, said, "If the end result of all of this were to diminish the number of women having mammograms, then that would be a tragedy."

        The Washington Post (11/19, A1, Stein, Eggen), the Wall Street Journal (11/19, A6, Wang, subscription required), the AP (11/19, Schmid), Bloomberg News (11/19, Greene), AFP (11/19), and Minnesota's Pioneer Press (11/19, Olson) also cover the story.

        Insurers seen as unlikely to alter mammography coverage. CNN (11/19) reports on the Situation Room that Sebelius said that "government health programs such as Medicaid will continue to cover routine mammograms." The government "will continue to recommend it, and the health plans have indicated that they will do the same," Sebelius said. "If the healthcare provider recommends a mammogram for a patient, they intend to cover that payment."

        USA Today (11/19, Szabo) notes that all insurance companies contacted by the paper said that "they will continue paying for annual mammograms amid widespread fears that new breast cancer screening guidelines from a federal task force could lead women to lose coverage for those tests." Likewise, in her statement, Sebelius said, "I would be very surprised if any private insurance company changed its mammography coverage."

        On the front of its Business Day section, the New York Times (11/19, B1, Singer, Abelson) also reports, "Health insurers, including the federal Medicare program, have said this week they were unlikely to change coverage of mammograms in the immediate wake of the new guidelines." In fact, "insurers like WellPoint, Aetna, Cigna and UnitedHealth Group" said that "they based their coverage decisions on a broad array of research and guidelines from various groups, many of which...continue to recommend more frequent screening."

        WSJournal argues guidelines show dangers of putting costs ahead of health. The Wall Street Journal (11/19, subscription required) editorializes that the US Preventive Services Task Force's decision on mammography guidelines is a good example of what federal healthcare reform will bring about given that the panel re-analyzed mammography data with healthcare spending as its focus and that the panel has no oncologist or radiologist members. The panel's recommendations will become rules if healthcare reform passes, the Journal argues, and putting health costs above health will become widespread.

        Emphasis on "anxiety" from mammogram false-positives is misguided, columnist writes. In a commentary in the New York Times (11/19, A35), columnist Gail Collins writes that "this week, a federal task force reported that most women don't need annual mammograms," but "the only thing that bothers me about the...report is all the emphasis on the 'anxiety' that might follow a false-positive." Collins notes that "we can manage anxiety." Rather, "the real problem with a test that creates a log of false-positive results is that it leads to a lot of other medical problems, some involving hospitals." And, "unless you are genuinely sick, there is no more dangerous place to be hanging around than a hospital," Collins contends.

Source: ASCO Cancer News

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