HHS Advisory Panel ‘Strongly’ Recommends Mammograms
The U.S. Preventive Services Task Force, an independent panel of experts that advises HHS on preventive medicine, yesterday issued new guidelines that "strongly recommend" that women between the ages of 40 and 69 undergo a mammogram every one to two years, the New York Times reports. The recommendation follows "months of controversy" over whether mammograms reduce breast cancer deaths (Stolberg, New York Times, 2/22). The committee analyzed eight large studies on mammograms and found "fair evidence" that women who underwent the test reduced their risk of death from breast cancer by about 20% over 10 years (Neergaard, AP/Philadelphia Inquirer, 2/22). "Our bottom line is that mammograms reduce deaths from breast cancer," Dr. Janet Allan, vice chair of the committee, said (Lueck, Wall Street Journal, 2/22). At a press conference announcing the new guidelines, HHS Secretary Tommy Thompson said, "Women are confused as to whether they should have their mammograms done or not. I wanted to make sure those women will go in and receive their mammograms" (Garvey, Los Angeles Times, 2/22). Last October, Danish researchers said that they had found "serious flaws" in the eight studies analyzed by the HHS advisory committee, which prompted advisers to the National Cancer Institute to conclude in January that the "benefits of breast cancer screening did not necessarily outweigh the risks" (New York Times, 2/22). Mammograms have a "high rate of anxiety-provoking false positives," which can lead to unnecessary biopsies in women. In addition, the test only detects breast abnormalities 80% to 90% of the time (Marsa, Los Angeles Times, 2/22). The HHS panel admitted that the studies had "flaws" but concluded that the "problems were not severe enough to dismiss the work" (New York Times, 2/22). The committee also found "insufficient evidence" that "routine" clinic breast examinations or self-examinations reduced deaths from breast cancer (HHS release, 2/21).
The announcement yesterday "reaffirms government backing" of mammograms, USA Today reports (Rubin, USA Today, 2/22). The recommendations announced yesterday represent the federal government's official policy on mammograms. Advocates for breast cancer patients -- who had feared that the controversy over mammograms would lead to decreased funding of programs that promote mammography and prompt health insurers to drop coverage for the tests -- praised the announcement. "Hopefully this will put to rest some of the controversy," Zora Brown, founder of the Breast Cancer Resource Committee, an advocacy group for African-American breast cancer patients, said (New York Times, 2/22). American Cancer Society President Robert Young said that the announcement "adds another reassuring voice" to the support of mammograms (AP/Philadelphia Inquirer, 2/22). However, Dr. Donald Berry, chair of the department of biostatistics at the M.D. Anderson Cancer Center in Houston and a member of the NCI advisory panel that raised doubts about mammograms in January, questioned the recommendations of the HHS advisory committee. He said, "They pooh-pooh some of the criticism" raised about the eight mammography studies, adding, "I'd like to know on what grounds." The results of the HHS committee's analysis will appear in the Annals of Internal Medicine in April. Thompson said, "Mammography is not a perfect tool," but added, "Mammography is an important and effective early detection tool that helps save lives" (New York Times, 2/22). To view excerpts of Thompson's announcement of the task force guidelines, go to http://www.nytimes.com/2002/02/22/national/22MAMM-TXT.html.