Firestorm follows US panel's ruling on mammograms (News Feature)

By Pat Reber Nov 19, 2009, 3:04 GMT

Washington - The US government moved Wednesday to quell a rising fury over the findings of an official panel that mammograms were no longer necessary for women in their 40s and that older women should have fewer tests for breast cancer.

US Secretary of Health and Human Services Kathleen Sebelius indicated that women should ignore the panel's findings, but she stopped short of criticizing or countermanding the panel's work.

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.

She urged women to '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.'

The firestorm broke out earlier this week when an independent, government-appointed panel - the US Preventive Services Task Force - published its recommendations 'against routine screening' because of 'serious negatives or harms' that need to be considered.

At the top of their list of concerns about mammographies was the anxiety created for women whose tests had false positives for cancer. The panel even urged against teaching and encouraging women to do routine self-examination, again because of the anxiety over lumps that turn out not to be cancer.

But the American Cancer Society, the American College or Radiology and other experts loudly insisted that mammography screening saves many lives when it starts at age 40 every one or two years, and is done annually for women over 50.

Daniel Kopans, a radiology professor at Harvard Medical School and breast cancer expert, told CNN that the panel that made the ruling included no oncologists or nationally-known radiologists. The panel was appointed under former president George W Bush's administration, Sebelius pointed out.

'Tens of thousands of lives are being saved by mammography screening, and these idiots want to do away with it,' Kopans told The Washington Post. 'It's crazy - unethical, really.'

Some critics wondered whether the recommendations were aimed at controlling spending on health care - a key issue in the debate over health insurance reform being pushed strongly by the administration of US President Barack Obama.

Republicans used the fracas to bolster their opposition to reform, warning that the panel's guidelines were the first step toward government dictates about what kind of health care people would receive.

'This is how rationing began,' said Congresswoman Marsha Blackburn on CNN. 'This is the little toe in the edge of the water. This is where you start getting a bureaucrat between you and your physician.'

Sebelius insisted that the panel did not set federal policy and that the government would continue paying for mammographies for people on federal health insurance like Medicare and Medicaid.

The debate over mammography is not new. Similar recommendations were made in 1997 by a committee of federal medical experts. The uproar was so loud that Congress convened hearings and overrode the findings.

A recent study funded by the National Cancer Institute showed that annual mammography for all women beginning at age 40 reduced the death rate from breast cancer by at least 15 per cent, the Post reported.

Breast cancer is the second leading cause of cancer death in women after lung cancer, the American Cancer Society says. In 2009, there have been 40,170 US deaths from breast cancer and 192,370 new cases of invasive breast cancer.

The organization attributes early detection through mammographies and other methods for the survival of about 2.5 million women currently living in the US.

Physicians worried that the panel's recommendations against preventive screening would deter women from seeking mammograms, after decades of a public push for them to do so.

In her statement, Sebelius lamented the 'great deal of confusion and worry among women ... across this country' caused by the panel's recommendations.