Legislators decry recommendation on mammograms

Insurers in Md. cover at age 40

Wednesday, Nov. 25, 2009

Maryland lawmakers are criticizing a controversial federal task force recommendation to delay breast cancer screenings for women, saying the current standard should remain.

The recommendation previously was for annual mammograms for women beginning at age 40, and many insurance companies have paid for that preventive treatment. However, a report released Nov. 16 states that regular screenings are unnecessary until age 50, causing concern that insurance companies could use the findings to deny coverage.

A Maryland law requires most insurance companies to provide coverage for women based on the American Cancer Society's position, which has been to begin screenings at 40.

There are some exceptions to the state mandate, according to a spokeswoman for the Maryland Insurance Administration. The annual screenings are not required for insurance plans purchased by small businesses, state or federal employees, employers based in other states and others.

The American Cancer Society has spoken out against the U.S. Preventive Services Task Force report, saying it will continue to support mammograms for women age 40 and beyond.

Del. Shane E. Pendergrass (D-Howard) said tying the state's mandate to the American Cancer Society's position means it is unlikely that Maryland lawmakers will have to act in order to maintain mammogram coverage for women younger than 50.

"There are times when we get criticized in the state of Maryland for having a lot of mandates," said Pendergrass, vice chairwoman of the House's Health and Government Operations Committee and a member of the health insurance subcommittee. "This is why we have mandates, because we want to make sure that people can get the health care that they need and have it be covered by insurance."

U.S. Secretary of Health and Human Services Kathleen Sebelius has said the report should be considered, but that it would not cause any immediate policy changes.

Pendergrass said she did not expect the cancer society to change its position anytime soon.

"The American Cancer Society continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40," Dr. Otis W. Brawley, chief medical officer of the American Cancer Society, said in a written statement. "Our experts make this recommendation having reviewed virtually all the same data reviewed by the [task force], but also additional data … 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."

The cancer society cited its own study from 2003 showing that mammograms reduce breast cancer mortality among women ages 40 to 74.

Del. Shirley Nathan-Pulliam (D-Baltimore), who has championed early breast cancer detection, especially among minority and low-income women, said that starting mammogram screenings earlier has saved lives. "I think changing that now is going to make things difficult for many people and increase mortality," she said.

Nathan-Pulliam, a registered nurse, predicted an outcry from women against the task force report. "I've seen the devastation of breast cancer," she said. "I'm definitely not in support of the new proposal. I don't buy any of it; I really don't. Let's continue with what we've been doing, which has been successful."

The recently elected chairwoman of the Maryland Republican Party, Audrey Scott, said the task force recommendation was a sign that Democrats were not properly representing the interests of women.

The U.S. Preventive Services Task Force, which issued the report, is an independent panel of private-sector experts in primary care and prevention.

The task force is sponsored by the Agency for Healthcare Research and Quality, a federal agency that is part of the U.S. Department of Health & Human Services.

ecunningham@gazette.net