The Detroit News

Advocates slam proposals for later, fewer screenings

Kim Kozlowski

December 10, 2009

After a decade of breast self-examinations, Cathy Sullivan discovered a lump at age 40. Tests later confirmed she had breast cancer.

Following surgery and treatment, Sullivan is now cancer-free. But she wonders what would have happened if she had followed a new federal recommendation that no longer recommends breast self-examinations.

“I may not be here today,” said Sullivan of Royal Oak.

Sullivan is among many women, doctors and advocacy organizations objecting to narrower breast cancer screening guidelines recently issued by the U.S. Preventative Services Task Force, a government panel. The guidelines reversed those in place for years, igniting an outcry from some who fear diminished cancer screenings for women, confusion among patients and rationed care with the federal effort to overhaul health care.

The recommendations were followed by new cervical cancer screening guidelines and prompted some to draw parallels to other controversial recommendations, such as those for prostate cancer screening.

But researchers say the new recommendations are based on studies showing that some surveillance tools do not necessarily lead to better health outcomes.

“For years, we’ve been trying to evaluate the evidence on what’s most appropriate and what to do,” said Dr. Mack Ruffin, a University of Michigan family medicine professor and physician at the U-M Comprehensive Cancer Center. “Often the recommendations fly in the face of what people know. There is evidence, and what you believe. You are going to go with what you believe.”

Screening guidelines are outlined for patients by advocacy groups, professional organizations and the government. Not all are the same.

The U.S. Preventative Services Task Force, which bases its recommendations on scientific research, concluded last month that routine mammograms should begin at age 50, as opposed to 40, to screen for breast cancer, the most common cancer in women outside of some skin cancers.

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