News | November 24, 2009

Healthcare Bill Excludes Mammograms for Women 40-49

November 24, 2009 – Several sections of Senate healthcare reform legislation would exclude mammography services for women 40-49, noted the American College of Radiology (ACR) in a public statement issued today.

The bill contains language stipulating that insurance entities such as private insurers, Medicare and Medicaid would only be required to cover services receiving a specific grade from the U.S. Preventative Services Task Force (USPSTF). Based on the USPSTF’s recent recommendation, this would exclude mammography services for women 40-49, would only require coverage of biennial coverage for women 50-74, and would exclude coverage for those 74 and older.

The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) gave the U.S. Department of Health and Human Services the authority to consider USPSTF recommendations in Medicare coverage determinations. Private insurers may also incorporate the USPSTF recommendations as a cost-savings measure.

In a public statement, the ACR warned that while these USPSTF recommendations may result in cost savings, a great many women will subsequently die unnecessarily from breast cancer as a result.

In the statement, James H. Thrall, M.D., FACR, chair of the ACR Board of Chancellors urges Congress to act to specifically protect annual mammography coverage for women ages 40 and older and for high risk women under 40 as recommended by their physician. “If the cost cutting USPSTF mammography recommendations are not excluded from healthcare reform legislation, the government or private insurers would be permitted to refuse women coverage for this life-saving exam, turning back the clock on two decades of advances against the nation’s second leading cancer killer,” said Thrall.

The federally funded and staffed Task Force includes representatives from major health insurers, but does not include a single radiologist, oncologist, breast surgeon, or any other clinician with demonstrated expertise in breast cancer diagnosis or treatment. Despite demonstration by their own analyses that screening annually beginning at age 40 saves the most lives and most years of life, the Task Force recommended against: mammography screening for women 40-49 years of age, annual mammograms for women between 50 and 74 (in favor of only every other year), and all breast cancer screening in women over 74. These recommendations run counter to even the Task Force’s own data and are out of touch with the long-proven policies of the American Cancer Society, ACR and other experts in the field.

“I strongly urge those in Congress to exclude the USPSTF guidelines from health care legislation and make changes to the Task Force membership and operating process that will guard against such unacceptable recommendations moving forward without any input from experts in breast cancer diagnosis and treatment,” said W. Phil Evans, M.D., FACR, president of the Society of Breast Imaging (SBI).

Since the onset of regular mammography screening in 1990, the mortality rate from breast cancer, which had been unchanged for the preceding 50 years, has decreased by 30 percent. According to the statement by the ACR, “ignoring direct scientific evidence from large clinical trials, the USPSTF based their recommendations to reduce breast cancer screening on conflicting computer models and the unsupported and discredited idea that the parameters of mammography screening change abruptly at age 50. In truth, there are no data to support this premise.”

The benefits vs. concerns of annual screening mammography starting at age 40

• Mammography has reduced the breast cancer death rate in the United States by 30 percent since 1990 ? hardly a small benefit.

• Based on data on the performance of screening mammography as it is currently practiced in the United States, one invasive cancer is found for every 556 mammograms performed in women in their 40s.

• Mammography only every other year in women 50-74 would miss 19 to 33 percent of cancers that could be detected by annual screening.

• Starting at age 50 would sacrifice 33 years of life per 1,000 women screened that could have been saved had screening started at age 40.

• Eighty-five percent of all abnormal mammograms require only additional images to clarify whether cancer may be present (or not). Only 2 percent of women who receive screening mammograms eventually require biopsy. The USPSTF data showed that the rate of biopsy is actually lower among younger women.

“Allowing a small number of people with no demonstrated expertise in the subject matter to make recommendations regarding diagnosis of a disease which kills more than 40,000 women each year makes no scientific sense and is a mistake that many women will pay for with their lives. Lawmakers need to require that the USPSTF include experts from the field on which they are making recommendations, and that its recommendations be submitted for comment and review to outside stakeholders in similar fashion to rules enacted by the Centers for Medicare and Medicaid Services,” said Thrall.

For more information: www.acr-arrs.org and http://www.acr.org/HomePageCategories/News/ACRNewsCenter/ExcludedUSPSTFR...

Related Content

Lunit Unveiling AI-Based Mammography Solution at RSNA 2018
News | Mammography | November 15, 2018
Medical artificial intelligence (AI) software company Lunit will be returning to the 104th Radiological Society of...
Breast Density Advocate Nancy M. Cappello Passes Away

Nancy Cappello. Image courtesy of AreYouDense.org.

News | Breast Density | November 15, 2018 | Jeff Zagoudis, Associate Editor
Imaging Technology News extends its condolences to the family, friends and colleagues of Nancy M. Cappello, Ph.D., who...
The MOZART Supra Specimen Tomosynthesis System is the latest generation of 3-D imaging for breast cancer surgery.
News | Breast Imaging | November 08, 2018
KUBTEC announced the launch of a new innovation in the treatment of breast cancer. The Mozart Supra Specimen...
Deaconess Health System Chooses Sectra as Enterprise Imaging Vendor
News | Enterprise Imaging | November 02, 2018
International medical imaging information technology (IT) and cybersecurity company Sectra will install its enterprise...
Volpara Enterprise Cloud Reaches 1 Million Mammograms Stored
News | Mammography | October 31, 2018
Volpara Solutions announced that the data stored in the Volpara Enterprise cloud now exceeds 1 million mammographic...
Etta Pisano Named American College of Radiology Chief Research Officer
News | Radiology Business | October 25, 2018
October 25, 2018 — Breast imaging research pioneer Etta Pisano, M.D., FACR, has been named...
DenseBreast-info.org Launches Patient Education Video Series
News | Breast Density | October 24, 2018
DenseBreast-info.org (DB-I) announced the release of "Let's Talk About Dense Breasts," a series of three informational...
Explaining the Mammography Quality Standards Act
Feature | Mammography | October 16, 2018
The Mammography Quality Standards Act (MQSA) was enacted to improve the quality of mammography and ensure that all...
iCAD Announces Positive Clinical Results for Artificial Intelligence Tomosynthesis Technology
News | Mammography | October 11, 2018
iCAD Inc. announced positive clinical results of its new digital breast tomosynthesis (DBT) cancer detection software,...
"Where's My Mammogram?" Campaign Helps Women Own Breast Health Records
News | Breast Imaging | October 10, 2018
October 10, 2018 — Mammosphere launched “Where’s My Mammogram?,” a public service campaign to help women obtain copie