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Friday, Nov. 20, 2009

Our View: Mammogram guidelines confusing

Test at 50, or now 40? Let's make sure we hear from breast cancer survivors.

Reaction has been loud and swift to new recommendations regarding mammograms and breast self-exams, which came from a government-sponsored group that provides guidance to doctors, insurance companies and policymakers.

Guidelines from the U.S. Preventive Services Task Force say that beginning in their 50s -- instead of at 40 -- women should get mammograms every other year, and shouldn't bother with breast self-exams.

But Health and Human Services Secretary Kathleen Sebelius on Wednesday said women should continue getting regular mammograms starting at age 40.

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

The American Cancer Society also continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40.

Otis W. Brawley, M.D., chief medical officer for the American Cancer Society said, "As someone who has long been a critic of those overstating the benefits of screening, I use these words advisedly: This is one screening test I recommend unequivocally, and would recommend to any woman 40 and over, be she a patient, a stranger, or a family member."

The guidelines are for the general population, not those at higher risk because of family history.

Still, the task force recommendations have left women confused.

Let's give the new guidelines time to be fully rolled out and vetted before taking drastic steps to change health care procedures.

As we look at health care reform, it is important to rein in out-of-control costs by reducing unnecessary tests. And stress and expense caused by false positives are valid concerns.

But the change in message on self-exams seems a step in the wrong direction, moving away from encouraging patients to be aware of changes in their bodies and responsible and pro-active in their health care.

As we reopen this debate about the best balance between preventive testing and going overboard, let's make sure we include the voices of survivors, especially those who might not be alive today if the revised recommendations had been in place when their cancer was detected.

Editorials are the opinion of the Merced Sun-Star editorial board. Members of the editorial board include Publisher Hank Vander Veen, Executive Editor Mike Tharp, Editorial Page Editor Keith Jones, Copy Desk Chief Jesse Chenault and Online Editor Brandon Bowers.