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Mammogram Task Force "Poor" Communicators; Two Opinions of Guidelines

The USPST apologized for poor communication, but sticks to its controversial mammogram guidelines.  (Photo: Getty Images/Jeff Kaufman)
The USPST apologized for poor communication, but sticks to its controversial mammogram guidelines. (Photo: Getty Images/Jeff Kaufman)

The U.S. Preventive Services Task Force (USPSTF) Wednesday appeared before Congress to acknowledge that their mammogram recommendations were poorly communicated.

“The task force communication was poor,” said Dr. Diana B. Petitti, the vice chairwoman of the U.S. Preventive Services Task Force, during a House Energy and Commerce Subcommittee hearing.  “The task force is saying that screenings starting at 40 should not be automatic, nor should they be denied. Many doctors and many women, perhaps even most women, will decide to have mammography screenings starting at age 40,” she said.

The task force did not retract their recommendations nor did they explain why those guidelines were established with no radiologist on the committee.  They did, however, admit that their timing — in the middle of a heated debate on health reform — was not optimal and that, again, they are not smooth talkers.  “The task force acknowledges that the language used … did not say what the task force meant to say,” Petitti said, adding that it is committed to improving its communication.

For the record, here is their original language used, which they did not mean to say but continue to recommend: “The USPSTF recommends against routine screening mammography in women aged 40 to 49 years.”

Physicians News Digest offers opinions on both sides of the task force recommendations.  Dr. Cathleen London, a family doc in Boston and clinical instructor at B.U. and Tufts, says of the guidelines:

“As physicians, it is always difficult to do less than to do more and not unexpected there has been quite a commotion regarding the new guidelines.  But we have to remember that increased testing can lead to harm.  In the case of earlier routine screening, the harms include: radiation exposure; pain during procedures; patient anxiety and other psychological responses; consequences of false-positive and false-negative tests; and overdiagnosis.”  Click here to read Dr. London’s full article.

On the other side of the aisle, Dr. Elizabeth Vliet, and internist and women’s health specialist, says:

“I think these new guidelines are detrimental to our goals of getting early detection and prompt treatment for women with breast cancer…. It makes no sense to me as a women’s health physician to suddenly decide to wait until an older age to screen for breast cancer when we know that survival is improved the earlier the diagnosis is made and treatment is begun.”  Click here for Dr. Vliet’s full article.

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