New recommendations for cancer screening don’t make sense

By Katie Wolf

When it comes to my health, I would rather be safe than be sorry. So when I heard on NPR that a federally appointed group of doctors was recommending women not start regular mammograms until the age of 50, instead of what used to be advised at age 40, I was confused. What could this mean? Why the change, and why now?

This past November, the U.S. Preventive Services Task Force revised its guidelines on the recommended age to start performing mammograms for women. CNN reports that the task force is made up of “16 health care experts, none of whom are oncologists.”

These new guidelines have been met with various reactions, but the loudest ones are those of dissent.

In a statement on their website, the American College of Radiology said: “If cost-cutting U.S. Preventive Services Task Force (USPSTF) mammography recommendations are adopted as policy, two decades of decline in breast cancer mortality could be reversed and countless American women may die needlessly from breast cancer each year.”

Also reported on CNN was a quote from the American Cancer Society “With its new recommendations, the (task force) is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them.”

These new guidelines are not recommending against all women in their 40s getting mammograms, but say that for most women in their 40s it is not necessary to do them routinely, as explained by Dr. Diane Petiti, vice chair of the USPSTF.

The task force explained that although mammograms can detect cancer in women between the ages of 40 and 49, the net benefit is small, as opposed to a moderate benefit for women in their 50s.

The task force also took into consideration the harm that can be done from the unnecessary testing, including stress, false-positive screenings and biopsies in women without cancer.

The task force has also advised against doctors teaching patients how to perform breast self-exams, giving this a “D recommendation” which means “There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.”

Regardless of their reasoning, the move by the task force is an unsettling one.

They’re concerned with the stress that a woman may go through when she gets a biopsy on something that may or may not be cancerous? They’re worried about the psychological harm women in their 40s go through when getting a mammogram?

What’s stressful to me is that I may someday have a doctor who takes this advice. If I’m one of the women who gets cancer in my 40s, but it goes undetected until I reach the age of 50, that means my cancer will have a higher chance of spreading, reducing my chances for survival and potentially killing me faster.

Getting a mammogram in my 40s is not going to be psychologically harmful, but I can guarantee that if I were dying in my 50s because I missed that mammogram 10 years earlier, my psyche would be plenty damaged.

I would like the task force to tell the countless amount of women (and men!) who first discovered their cancer on their own, possibly saving their lives, that self-examinations have no benefit and could even be harmful.

I perform breast self-examinations regularly, and I don’t plan on stopping because this task force says it isn’t helpful. I hope that my attempts are in vain and I never have to worry about finding a lump, but if I do I’ll be glad I caught it early.

What’s so frustrating is that this gives women another excuse to put off going to their doctor and taking care of business. As if they need it.

Every year I get the card in the mail from my OB-GYN stating that it’s time for my yearly physical and I groan, “How can I put this off?” The dentist? No way do I want to take time out of my day for a teeth cleaning. My health is important, and these are appointments I have to go to whether I like it or not. But if I have a chance to postpone my doctor visits or skip completely, I’m sorely tempted — and I don’t think I’m alone in my sentiments.

Now women can say “Oh, well they say I don’t have to worry about breast cancer until I’m 50, so I guess I’m free and clear for another 10 years!” And in the meantime, their cancer could be spreading.