U.S. health chief: No change on mammogram policy

November 18, 2009
4:37 p.m. EST

Health and Human Services Secretary Kathleen Sebelius tells women: "Keep doing what you have been doing for years.

Washington (CNN) -- A federal advisory board's recommendation that women in their 40s should avoid routine mammograms is not government policy and has caused "a great deal of confusion," Health and Human Services Secretary Kathleen Sebelius said Wednesday.

"My message to women is simple. Mammograms have always been an important life-saving tool in the fight against breast cancer, and they still are today," Sebelius said in a statement.

"Keep doing what you have been doing for years: talk to your doctor about your individual history, ask questions and make the decision that is right for you."

With her statement, Sebelius waded into the controversy over Monday's announcement by the U.S. Preventive Services Task Force that women in their 40s should not get routine mammograms for early detection of breast cancer.

Sebelius' statement is aimed at "making it clear these recommendations are not ours," a White House source said.

Sebelius said the doctors and scientists on the task force "do not set federal policy, and they don't determine what services are covered by the federal government."

"The task force has presented some new evidence for consideration, but our policies remain unchanged," she said. "Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action."

Though the Preventive Services Task Force is independent, the Department of Health and Human Services' Web site calls the panel's recommendations the "gold standard," and insurance companies look to the panel for guidance on which preventive care practices they should cover.

With the Obama administration fighting to push a sweeping overhaul of U.S. health insurance through Congress, Republicans quickly jumped at the chance to attack the mammography report.

"This is how rationing begins," said Rep. Marsha Blackburn, R-Tennessee. "This is the little toe in the edge of the water. And this is where you start getting a bureaucrat between you and your physician."

"Absolutely not," the White House said in a statement posted on its Web site.

"While the bills are still being drafted and debated in Congress, health insurance reform legislation generally calls for the task force's recommendations to help determine the types of preventive services that must be provided for little or no cost," it said. "The recommendations alone cannot be used to deny treatment."

Criticism of the recommendation has come from quarters other than opponents of the Democratic health care bills, however. The American Cancer Society said it disagrees with the findings of the task force and continues to recommend annual screening, including mammograms, for all women beginning 40 and over.

"With its new recommendations, the [task force] is essentially telling women that mammography at age 40 to 49 saves lives, just not enough of them," said Dr. Otis Brawley, the group's chief medical officer.

And Rep. Debbie Wasserman-Schultz, D-Florida, who was diagnosed with early stage breast cancer at 41, called the panel's recommendations "really disturbing" and "absolutely irresponsible."

"It's a very patronizing attitude that these scientists have taken," she said. "It's pretty outrageous to suggest that women couldn't handle more information."

Rep. Frank Pallone Jr., chairman of the House Energy and Commerce's Subcommittee on Health, has announced that he will lead hearings into the advisory board's recommendations.

Wasserman-Schultz said those hearings "will help us reach the appropriate policy conclusion, which I believe is that these recommendations should be set aside."

Breast cancer is the most common cancer for U.S. women, with nearly 200,000 women expected to be diagnosed with the invasive form of the disease this year, according to the American Cancer Society. The organization said it disagrees with the findings of the task force and continues to recommend annual screening, including mammograms, for all women beginning 40 and over.

For women 50 to 74, it recommended routine mammography screenings every two years. Risks and benefits for women age 75 and older are unknown, it said.

The group's previous recommendation was for routine screenings every year or two for women age 40 and older.

While roughly 15 percent of women in their 40s detect breast cancer through mammography, data show that many other women experience false positives, anxiety, and unnecessary biopsies as a result of the test, according to the task force.

The Preventive Services Task Force reviews medical data and bases recommendations on effectiveness and risks involved. It is composed of 16 health care experts, none of whom are oncologists, though a team of cancer experts presented its findings to the group.

CNN's Danielle Dellorto and Gloria Borger contributed to this report.

http://www.cnn.com/2009/HEALTH/11/18/ma ... gletoolbar