Congress May Be Forced To Intervene Again On Mammogram Recommendations
STEVE INSKEEP, HOST:
Who should guide this nation's medical advice? When it comes to mammograms, federal experts are saying one thing. Congress says another.
RENEE MONTAGNE, HOST:
Six years ago, the U.S. Preventive Services Task Force declared that women under 50 may not need to get routine mammograms. Afterward, Congress passed legislation to override the group's recommendation. So now the task force is updating its guidelines.
INSKEEP: Yet in a draft released last week, the group essentially repeated its earlier recommendation. It still discourages women from taking a test they commonly get for free. NPR's Juana Summers reports on a potential confrontation with Congress.
JUANA SUMMERS, BYLINE: She's a wife and a working mother of three. And in December 2007, she got a diagnosis that no one wants. Like many thousands of women in the United States, she had breast cancer, a disease that will kill roughly 40,000 women this year. While the National Cancer Institute says women between the ages of 55 and 64 are at the highest risk of being diagnosed with breast cancer, 11 percent of those diagnosed each year are under the age of 44.
CONGRESSMAN DEBBIE WASSERMAN SCHULTZ: Forty-one - I was - I had just had my first mammogram a few months before I found the lump.
SUMMERS: That is Debbie Wasserman Schultz, a member of Congress from Florida who also chairs the Democratic National Committee. Diagnosed at 41 years old, she says that if the recommendation had been in place, she may not have gotten a mammogram and her own cancer wouldn't have been caught early. What's more, she says the task force is essentially handing women a death sentence.
SCHULTZ: We know that there are women that will die if this recommendation goes through.
SUMMERS: Here's what the task force found; mammograms are most beneficial for women between the ages of 50 and 74. Benefits for women 75 and older are unclear. When it comes to women in their 40s, the task force is sticking by its earlier guidance and isn't issuing a blanket recommendation in favor of mammograms. That contradicts the stance of high-profile groups like the American Cancer Society and the American College of Radiology, both of which recommend annual mammograms beginning at 40. When these new recommendations were first issued back in 2009, Democrats and Republicans alike were highly critical. Former Congressman Phil Gingrey, a Georgia Republican who worked as an OB-GYN, had this to say at a hearing six years ago.
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PHIL GINGREY: You put doctors in an untenable position, and you put their patients at risk of death.
SUMMERS: Missouri Republican Roy Blunt, then serving in the House, put it this way.
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SENATOR ROY BLUNT: These new guidelines - or these new proposed guidelines - have caused a great deal of confusion for women. I believe it's a huge mistake to send a message to women and their families that an early alert system is not beneficial - or may not be beneficial.
SUMMERS: While some who disagree with the task force's recommendations worry they will discourage women, particularly those under age 50, from having mammograms, others worry that women who do have the test may find it's no longer covered by their insurance. In 2009, as Congress was grappling with the Affordable Care Act, this recommendation proved so controversial that Congress passed an amendment to the health care law that in effect required the federal government to ignore it. But that only applied to the original 2009 recommendation and not to some future version. Here's Wasserman Schultz.
SCHULTZ: We may need to act legislatively again. But my hope is that the task force will see how much disagreement there is over their recommendation and will revise it.
SUMMERS: If Congress does want to override the task force recommendation a second time, lawmakers may have to separate it from the larger debate over Obamacare. Juana Summers, NPR News, Washington.
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