who appointed this new group?

In Reversal, Panel Urges Mammograms at 50, Not 40

Gina Kolata | Nov 17

NYT - Most women should start regular breast cancer screening at age 50, not 40, according to new guidelines released Monday by an influential group that provides guidance to doctors, insurance companies and policy makers.

The new recommendations, which do not apply to a small group of women with unusual risk factors for breast cancer, reverse longstanding guidelines and are aimed at reducing harm from overtreatment, the group says. It also says women age 50 to 74 should have mammograms less frequently — every two years, rather than every year. And it said doctors should stop teaching women to examine their breasts on a regular basis.

Just seven years ago, the same group, the United States Preventive Services Task Force, with different members, recommended that women have mammograms every one to two years starting at age 40. It found too little evidence to take a stand on breast self-examinations.

The task force is an independent panel of experts in prevention and primary care appointed by the federal Department of Health and Human Services.

Its new guidelines, which are different from those of some professional and advocacy organizations, are published online in The Annals of Internal Medicine They are likely to touch off yet another round of controversy over the benefits of screening for breast cancer.

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If you're a railroad expert, you may very well be led to find that best practices require lots more rail equipment, facilities, and jobs. If only tool is a hammer, and all that. The frequency of C-sections (more convenient and lucrative than the alternative) in the U.S. appears to be driven by obstetricians, so I'd be wary of best practices panels composed only of obstetricians saying we ought to continue the high incidence.

Seems to me another indication that medical services should not be a for-profit enterprise.

Erm as fascinating as the back-n-forth among appointees and the medical hoi polloi is, I would like to know more about whether this screening process imparts enough radiation to have a biological impact - particularly if it is an annual affair.

All EM radiation should be under a schema of regulatory clarity, much as all drugs/alcohol/tobacco should be under one schema. The people that are running this gig do NOT want some kind of regulation on hot things like cell phone towers. Radioactive medical imaging is usually said to be only 50x higher than background or whatever, but is this always true??

It is physically impossible for it to have a null effect - the most benign possible claim is that it's statistically insignificant. If in fact it's getting false positives then it could easily have a negative effect on public health as a whole, via misdirecting limited resources. (I am more concerned about non-medical radiation but it's the same basic pandora's box no one wants to open)

(ref this article http://www.naturalnews.com/027537_mammograms_cancer_industry.html )
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Hongpong.com

November 20, 2009
Guidelines Push Back Age for Cervical Cancer Tests

By DENISE GRADY

New guidelines for cervical cancer screening say women should delay their first Pap test until age 21, and be screened less often than recommended in the past.

The advice, from the American College of Obstetricians and Gynecologists, is meant to decrease unnecessary testing and potentially harmful treatment, particularly in teenagers and young women. The group’s previous guidelines had recommended yearly testing for young women, starting within three years of their first sexual intercourse, but no later than age 21.

Arriving on the heels of hotly disputed guidelines calling for less use of mammography, the new recommendations might seem like part of a larger plan to slash cancer screening for women. But the timing was coincidental, said Dr. Cheryl B. Iglesia, the chairwoman of a panel in the obstetricians’ group that developed the Pap smear guidelines. The group updates its advice regularly based on new medical information, and Dr. Iglesia said the latest recommendations had been in the works for several years, “long before the Obama health plan came into existence.”

She called the timing crazy, uncanny and “an unfortunate perfect storm,” adding, “There’s no political agenda with regard to these recommendations.”

Dr. Iglesia said the argument for changing Pap screening was more compelling than that for cutting back on mammography — which the obstetricians’ group has staunchly opposed — because there is more potential for harm from the overuse of Pap tests. The reason is that young women are especially prone to develop abnormalities in the cervix that appear to be precancerous, but that will go away if left alone. But when Pap tests find the growths, doctors often remove them, with procedures that can injure the cervix and lead to problems later when a woman becomes pregnant, including premature birth and an increased risk of needing a Caesarean.

Still, the new recommendations for Pap tests are likely to feed a political debate in Washington over health care overhaul proposals. The mammogram advice led some Republicans to predict that such recommendations would lead to rationing.

Senator Tom Coburn, a Republican from Oklahoma who is also a physician, said in an interview that he would continue to offer Pap smears to sexually active young women. Democratic proposals to involve the government more deeply in the nation’s health care system, he said, would lead the new mammography, Pap smear and other guidelines to be adopted without regard to patient differences, hurting many people.

“These are going to be set in stone,” Mr. Coburn said.

Senator Arlen Specter, a Pennsylvania Democrat and longtime advocate for cancer screening, said in an interview: “And this Pap smear guideline is yet another cut back in screening? That is curious.” Mr. Specter, who was treated for Hodgkin’s lymphoma in 2005 and 2008, said Congress was committed to increasing cancer screenings, not limiting them.

Representative Rosa DeLauro, Democrat of Connecticut, said that the new guidelines would have no effect on federal policy and that “Republicans are using these new recommendations as a distraction.”

“Making such arguments, especially at this critical point in the debate, merely clouds the very simple issue that our health reform bill would increase access to care for millions of women across the country,” she said.

There are 11,270 new cases of cervical cancer and 4,070 deaths per year in the United States. One to 2 cases occur per 1,000,000 girls ages 15 to 19 — a low incidence that convinces many doctors that it is safe to wait until 21 to screen.

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