Under pressure from doctors, some women’s groups and imaging equipment makers, lawmakers are likely to require coverage for more mammograms in health reform legislation than is currently recommended by the U.S. Preventive Services Task Force, the Wall Street Journal reports.
According to the Journal, many doctors’ and patients’ groups in recent years have formed alliances — such as sponsorships, joint events and endorsements — with companies that make mammography equipment. The groups and their corporate partners “swung into action” in November 2009 after USPSTF issued new guidelines suggesting that routine mammograms were not necessary for women in their 40s who have normal cancer risk, the Journal reports. USPSTF said the risks associated with annual mammograms — such as false positives, unnecessary treatment and low-level radiation exposure — could outweigh the benefits for many women in their 40s. The panel recommended that women ages 50 through 74 receive mammograms biennially.
The new recommendations “sowed unease and confusion,” including among major medical societies that disagree with USPSTF, the Journal reports. Advocacy groups stepped up lobbying, and their supporters “swamped lawmakers with angry calls and e-mails” urging them to guarantee access to mammograms under health reform legislation, the Journal reports.
The House in December 2009 voted 426-0 for a nonbinding resolution — named for Rep. Debbie Wasserman Schultz (D-Fla.), a breast cancer survivor — saying that insurers should not use the USPSTF recommendations to deny coverage for routine mammograms. The Senate adopted a similar amendment by Sen. Barbara Mikulski (D-Md.) to its health reform bill (HR 3590). Congressional aides say that a version of the amendment is likely to be in the final bill.
Meanwhile, a few women’s health groups that receive little or no corporate financing are standing behind the USPSTF guidelines. Fran Visco, founder of the National Breast Cancer Coalition, said, “The guidelines were always going to create a firestorm because they threaten some groups’ existence.” Adriane Fugh-Berman, a professor at the Georgetown University School of Medicine, said, “You have to ask if there’s a conflict of interest, because breast cancer advocacy has become big business.”
Sen. Chuck Grassley (R-Iowa) last month sent letters to 33 major not-for-profit groups requesting that they disclose their industry funding. The American Cancer Society said that it had received less than $1 million from screening device makers over the past five years, a sum that its spokesperson said is small compared with its more than $1 billion in annual revenue. The money does not influence ACS’ recommendations, the spokesperson added. Nancy Brinker — co-founder of Susan G. Komen for the Cure, which has received money through partnerships with GE — said the organization has always pushed for early detection (Mundy, Wall Street Journal, 1/12).
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