December 10, 2009

Women in Scotland County Don’t Need to Fear New Mammogram Recommendations

When a federal task force recently announced its new breast cancer screening guidelines, women in Memphis and around the nation were left wondering what to do.

The uproar came from the U.S. Preventive Services Task Force suggestion that women under the age of 50 didn’t need mammograms. Women aged 50 to 74 are now advised to get mammograms every two years. These changes reversed the recommendations the task force made in 2002, which stated women should begin getting annual mammograms at age 40. After reviewing the data, the task force concluded that the risks such as false alarms, anxiety, and unneeded medical tests outweighed the benefits of screening before the age of 50.

The U.S. Preventive Services Task Force is an independent panel of 16 health care experts. The panelists review medical data and develop recommendations for doctors, insurance companies and policy makers.

Not everyone agrees with the task force’s new guidelines. The American Cancer Society, American College of Obstetricians and Gynecologists, and Susan G. Komen for the Cure continue to support the old standard of getting annual mammograms starting at age 40. Breast cancer survivors and advocates also raised an outcry about the potential negative impacts of delayed screening. Another concern is that the recommendations would cause insurance companies to restrict their coverage to women 50 and older.

However, for years nations such as Canada, England and France have recommended screening starting at age 50. It should be noted that the United States currently has the highest rate of breast cancer survivorship in the world.

“The recommendations we’ve used for the last decade have been extraordinarily successful in detecting breast cancers earlier and starting appropriate treatment sooner,” said Professor Jane Armer, Ph.D., RN, MU Sinclair School of Nursing, and a researcher in post-breast cancer survivorship. “Changes to current screening recommendations need to be made carefully with full awareness of possible consequences in delayed breast cancer diagnosis among women.”

Armer added that earlier detection and advances in treatment has lowered number of deaths even as the number of women diagnosed with breast cancer has risen.

Dr. Diana Petitti, vice chair of the task force, said in a statement that starting at age 40, women were advised to “make an appointment with their doctors and discuss the benefits and harms of having a mammogram now versus waiting until age 50.” All of these guidelines only apply to those women with no family histories or risk factors that would lead to a higher rate of breast cancer.

Breast cancer is the most commonly diagnosed cancer in the United States and in Missouri. According to the American Cancer Society, in 2008 it was estimated that there would be 3,810 new cases of breast cancer and 890 deaths in Missouri. In Scotland County, from 1997 to 2005, 32 people were diagnosed with breast cancer. During a similar span from 1996 to 2006, 7 people in Scotland County died from breast cancer.

For those women concerned about how to pay for breast cancer screening, there are programs available. Medicare is one of those programs. Women with Medicare that are 35- to 39-years old are covered for one baseline mammogram. Women 40 and older with Medicare are covered for an annual screening mammogram. A doctor’s prescription or referral is not necessary for Medicare payment.

Those without private insurance or Medicare may qualify for Missouri’s Show Me Healthy Women program. This program provides free breast and cervical cancer screenings to age- and income-eligible women. In addition, those diagnosed with breast or cervical cancer through this program will receive support for cancer treatment. In Scotland County there is one breast and cervical cancer provider. To find the provider closest to you, go to:

The key messages Health Literacy Missouri advises women to remember on the issue of breast cancer screening are:

* Be familiar with your own breasts so you can recognize changes in them

* Talk to your doctor about your individual and family histories

* Ask your doctor questions

* Make the decision that’s right for you regardless of your age.

For more information about the services in your area, contact the Missouri Department of Health and Senior Services or go to:

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