The reaction was markedly different than the blowback from patient advocates that occurred when the federal advisory group previously suggested less frequent cancer screenings.
In November 2009, the task force reversed its longstanding recommendation that most women should have breast cancer screenings every one to two years starting at age 40. Instead, regular mammograms should wait until women are 50 years old, the group advised.
The recommendations by the administration-appointed group of physicians are important because they are used by many public and private insurers in coverage decisions for tests. And such coverage (or the lack thereof) frequently determines patient usage, patient advocates have argued.
The reaction from advocates to the recommendation for less-frequent breast cancer screening ranged from outrage to worse. It also created a political problem for the Obama administration at the height of the contentious congressional debate over the Patient Protection and Affordable Care Act, which faced criticisms that provisions—such as the Independent Payment Advisory Board—would limit care to save the government money. The cancer dust-up led to the addition of language to the healthcare legislation specifically barring limitations on breast cancer screenings.
So how did the same federal advisory group pull off another cancer screening-reduction recommendation with polar opposite results?
“My guess is that one factor is that there was a lot of reaction to the mammography recommendations,” Debbie Saslow, director of breast and gynecologic cancer at the American Cancer Society, said in an interview. “That gave them incentive to try to open up the process more in the future.”
That new process for the federal advisory group included coordinating with the patient advocacy group for the first time to conduct simultaneous reviews of the same research data on cervical cancer screening efficacy before issuing its recommendation for less frequent screenings. Advocates' acceptance of the task force's recommendations also was helped by the similarities between those changes and testing guidelines that the American Cancer Society produced this week after its own data review.
“The difference for cervical cancer is that for breast cancer you can actually miss cancers from one year to the next and mammograms only detect the actual cancer,” she said. “Cervical screenings find cervical changes before they become pre-cancer, finds pre-cancer before they become cancer and that whole process takes 10 to 20 years.”
Follow Rich Daly on Twitter @MHRDaly.