Central Illinois Doctors Speak Out Against New Mammogram Guidelines / Dr. Jessica Guingrich

Doctors speak out again Mammogram Guidelines

Dr. Lynne Jalovec, left, a breast cancer surgeon, and Dr. Jessica Guingrich, a radiologist, treat patients at OSF Saint Francis Centers for Breast Health.

PEORIA — As thousands of women and their families walk, run and race for the cure Saturday, two local doctors worry the progress made in treating breast cancer may be in jeopardy.

Their concerns stem from the latest national proposal to reduce routine mammogram screenings. This time around, the proposed recommendations are as controversial as they were in 2009 when the U.S. Preventive Services Task Force (USPSTF) first challenged the ritual of the annual mammogram.

Dr. Jessica Guingrich and Dr. Lynne Jalovec, a radiologist and surgeon, respectively, along with OSF Saint Francis Centers for Breast Health, are urging women to speak out against the task force’s updated recommendations which, again, call for changing the guidelines from annual mammograms beginning at age 40 to mammograms every other year beginning at 50.

The two doctors’ fear a domino effect if the recommended guidelines are finalized, particularly if the recommended age is raised to 50. Insurers could stop covering annual mammogram screenings, women could stop getting mammograms annually or wait later to start, more and more breast cancers would be diagnosed at later stages, more intensive and invasive treatments would be required, and, ultimately, breast cancer-related deaths would increase.

“Right now we have a tool that’s saving lives and to see that tool manipulated is upsetting,” Jalovec said. The uproar about the original recommendations stopped the potential restricted insurance coverage in 2009, she added.

The task force, an independent panel made up of experts in evidence-based preventive care, is accepting public comments on the proposal until May 18 at www.screeningforbreastcancer.org.

The panel’s recommendations reiterate previous guidelines but also attempt to clarify its position on mammograms for women between the ages of 40 and 49 — leaving the decision up to a woman and her doctor unless there is a family history of breast cancer.

But Guingrich said that’s not clearer or better. “The fact is 75 percent of women who have breast cancer diagnosed between the ages of 40 and 49 have no family history of breast cancer.”

The task force does not make recommendations for or against insurance coverage, Dr. Kirsten Bibbins-Domingo, a vice chairwoman of the task force, said in an emailed response.

Under the Affordable Care Act, private insurance plans rely on task force recommendations to set minimum coverage requirements. Blue Cross Blue Shield of Illinois, the state’s largest health insurer, uses recommendations from the preventive services task force and several other organizations to help set policy on medical coverage, according to a spokeswoman.

Advocates of annual mammogram screenings are up against increasing scrutiny of unnecessary medical testing and treatments throughout the nation’s health care system.

After a systematic review of scientific evidence, the task force concluded the risks of over-diagnosis and unnecessary treatment outweigh benefits of mammograms for women between the ages of 40 and 49. Women in the 50-to-74 age range benefit the most from screenings conducted every other year.

But Guingrich and Jalovec argue the recommendations, as presented, are based on flawed or out-of-date research.

“I think what’s happening is a crime,” Guingrich said. “I’m not looking out for my interests, I’m looking out for my patients’ interests.”

Task force recommendations

The U.S. Preventive Services Task Force is updating its recommendations on breast cancer screenings.

Susan G. Komen for the Cure and major medical groups representing surgeons and radiologists still support annual mammograms beginning at 40. The American Cancer Society, also a proponent, is in the process of reconsidering its position.

But the task force, an independent volunteer panel, would like to see women start later and get screened less often. Under the Affordable Care Act, private insurance plans must cover procedures rated as an “A” or “B” by the task force with no out-of-pocket expenses.

The task force is soliciting public comments on proposed recommendations on screening for breast cancer. Comments can be submitted until May 18 to www.screeningforbreastcancer.org orwww.uspreventiveservicestaskforce.org/Comment/Collect/Index/RecommendationStatementDraft/breast-cancer-screening1.

The recommendations, by age group:

► 40-49: Recommends informed, individualized decision-making based on a woman’s values, preferences and health history. (C)

► 50-74: Recommends mammography every two years. (B)

► 75 and older: More research needed. Current science is inadequate to recommend for or against.

Source: U.S. Preventive Services Task Force, www.uspreventiveservicestaskforce.org


 

Original Article: http://www.pjstar.com/article/20150508/NEWS/150509183/?Start=2

Pam Adams can be reached at 686-3245 and padams@pjstar.com. Follow her on Twitter @padamspam.