The Mammogram Debate

New recommendations elicit emotionally-charged responses.

News items that are posted on the Web are usually followed by a little box in which comments can be typed and then posted. Most news items either generate no responses or seem to have just a few comments, and the comments are typically short and to the point. The release of the US Preventive Services Task Force's new mammography recommendation that women between 40-50 years old do not need annual mammograms has unleashed a rash of responses. On the ABCNews.com, 265 people posted lengthy comments within three days of the release of the USPTF report. The American Cancer Society and the American College of Obstetrics and Gynecology were among the first organizations to publicly oppose the recommendations. In the meantime, people in the US (particularly women) are angry or confused.

One of the people posting a comment on the abcnews.com site wrote, "So, a group of sixteen so called 'experts,' who do not count a single oncologist in their midst, have taken it upon themselves to confuse millions of women by recommending a change to the guidelines, increasing the screening age from 40 to 50 for women 'who are not at risk' and recommending against self exams as they are a 'waste of time.' They claim to have analyzed reams of data but, it would appear they missed the most critical statistic of them all, namely that 75% to 90% of newly diagnosed breast cancer victims are women who had no previous or family history of the disease. To be candid, I am pretty mad about the arrogance and condescending attitude of these people who want to play God! How dare they condemn women to death through their supercilious and detached attitude? Their recommendations are an insult and a slap in the face to the women of America."

There were a number of personal stories posted, such as this one, "I was diagnosed with breast cancer at 45. No other member in my immediate family was diagnosed with breast cancer. Therefore, the thought of having breast cancer had not come to my mind. Had I not been aware of my body changes and the availability of mammograms, perhaps I would be dead today. I thank God for the availability of mammograms. I will celebrate my 53rd birthday next month."

The opportunity to post comments to news stories, and the fact that so many people actually take the time and make the effort to post a comment, provides a barometer that tells us how the public is feeling about a particular issue. I read all of the comments made in response to the USPTF mammography recommendations on the abcnews.com site and found that not a single one supported the new recommendations. Women will likely do what they want to do as far as mammogram frequency and when to start having these exams goes. The stickler will be who will pay for the mammograms done between the ages of 40-50. If insurance companies follow the USPTF recommendations and only reimburse for mammograms performed after age 50, then women themselves will need to pay out of pocket and that may influence their decision about having mammograms between the ages of 40 and 50.