August 11, 2015 — The American College of Radiology (ACR) and the Society of Breast Imaging (SBI) are encouraging congressional leaders to pass the Protecting Access to Lifesavings Screenings Act (H.R. 3339). Passage of the act would ensure women who want to get regular mammograms retain insurance coverage with no copay and avert thousands of unnecessary deaths.
The ACR and SBI strongly support the PALS Act as a way to delay implementation of draft breast cancer screening recommendations from the United States Preventive Services Task Force (USPSTF) for two years. They singled out Reps. Renee Ellmers (R-NC) and Debbie Wasserman Schultz (D-FL) for introducing H.R. 3339 and encouraged the House and Senate to act quickly to pass the legislation.
"The two-year delay allows consideration of recent large studies that showed mammography to be far more effective than the old studies the USPSTF analyzed. It also provides time for Congress to enact separate legislation that mandates a badly needed overhaul of the closed and outdated USPSTF process," said Debra Monticciolo, M.D., FACR, chair of the American College of Radiology Breast Imaging Commission.
The Affordable Care Act (ACA) requires private insurers to cover exams without patient cost sharing given a grade of "B" or higher by the USPSTF. The Task Force gave routine screening of women ages 40-49 a "C" grade and gave a "B" grade only to biennial (every other year) screening for women 50-74. This would indicate that women ages 40-49 that choose routine screening and those 50-74 who want annual screening would not be guaranteed coverage. This may drastically impact underserved and rural areas.
According to National Cancer Institute data, since mammography screening became widespread in the mid-1980s, the U.S. breast cancer death rate has dropped 35 percent. Published analysis, using the task force’s 2009 methodology, showed that if women ages 40-49 go unscreened and those 50-74 are screened biennially, approximately 6,500 additional women each year in the United States would die from breast cancer. Many more would experience more extensive and expensive treatments than if their cancers were found early by a regular mammogram.
"The closed USPSTF process does not meet Institute of Medicine (IOM) standards for 'trustworthy' guidelines creation and needs updating. These USPSTF mammography recommendations are suspect until ACR and SBI recognized experts are included in a meaningful way in their creation," said Elizabeth A. Morris, M.D., FACR, president of the Society of Breast Imaging.