- The Washington Times - Thursday, November 19, 2009

Health and Human Services Secretary Kathleen Sebelius rejected an independent panel’s advice that breast-cancer screenings be delayed for women in their 40s in the face of a backlash by Republicans, who argued the report is a taste of things to come under a Democratic health care system.

Mrs. Sebelius advised women to “keep doing what you have been doing for years,” despite the recommendations of the U.S. Preventive Services Task Force (USPSTF), which she said were nonbinding, would not affect federal medical policy, and should not affect private insurance companies.

“There has been debate in this country for years about the age at which routine screening mammograms should begin, and how often they should be given,” Mrs. Sebelius said. “The task force has presented some new evidence for consideration, but our policies remain unchanged.”

Task force recommendations “don’t determine what services are covered by the federal government,” she said, adding that she was speaking out now because the recommendations “have caused a great deal of confusion and worry among women and their families across this country.”

The task force recommended Monday that women wait until age 50 to get their first mammogram, and then repeat every two years instead of every year. The board also advised against teaching women to do regular self-exams and that even exams performed by doctors were unlikely to prove fruitful.

The report, which reversed the panel’s previous recommendations and contradicted what cancer-prevention experts have advised for years, was met with disbelief by organizations such as the American Cancer Society, which quickly reiterated its support for mammograms starting at age 40.

“Our experts make this recommendation having reviewed virtually all the same data reviewed by the USPSTF, but also additional data that the USPSTF did not consider,” said Dr. Otis W. Brawley, the American Cancer Society’s chief medical officer. “When recommendations are based on judgments about the balance of risks and benefits, reasonable experts can look at the same data and reach different conclusions.”

Meanwhile, Republicans said the recommendations foreshadowed limits on health care access that they say will occur under legislation advocated by the Obama administration. Proposals by congressional Democrats all state that they will control medical costs.

Six Republican members of Congress, including Rep. Sue Myrick of North Carolina, a 10-year breast-cancer survivor, dismissed Mrs. Sebelius’ assurances that the recommendations would not affect federal policy.

“This is a first step in the direction of rationing of care based on cost,” said Rep. Phil Gingrey, a Georgia Republican who spent 26 years as a practicing obstetrician/gynecologist. “What you just heard from the U.S. Preventive Services Task Force might be guidelines today, but if this [bill] passes, it will no longer be guidelines, it will have the full force of law.”

Rep. Rosa DeLauro, Connecticut Democrat, dismissed that charge as “Republicans’ political gamesmanship.” She said that “to suggest that our bill … does anything other than reduce cost, ensure that insurers stop discriminating against women … is absurd.”

Mrs. Sebelius also said that insurance coverage would likely remain unchanged.

“Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action,” she said.

Almost 200,000 American women are diagnosed with breast cancer every year, and more than 40,000 die, according to the National Breast Cancer Foundation. One woman in eight will develop breast cancer at some point during her life, the foundation states.

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