Doctor, lawyer upbraid Congress for ‘undermining science’ on mammo screening

Hot on the heels of final-draft guidelines from the U.S. Preventive Services Task Force (USPSTF) on screening mammography comes blistering commentary from two Georgetown University professors—one a physician and the other an attorney—taking Congress to task for the way it has acted to implement the recommendations.

The USPSTF guidelines, published Jan. 12, call for women at average risk for breast cancer to have a screening mammogram every other year beginning at age 50 and continuing to 74.

For women in their 40s, the decision to start screening mammography “should be an individual one,” the USPSTF advises by way of giving this option its “C” grade, potentially letting insurers off the hook. “Women who place a higher value on the potential benefit than the potential harms may choose to begin screening every two years between the ages of 40 and 49 years.”

On Jan. 18, JAMA published a Viewpoint piece by Georgetown’s Kenneth Lin, MD, MPH, and Lawrence O. Gostin, JD, stating that the recently passed Consolidated Appropriations Act effectively forces private insurers to follow not the latest USPSTF guidelines but those from 2002.

The earlier version recommended screening every one to two years starting at age 40.

“Although many women’s health advocates applauded the congressional mandate, it actually undermines women’s rights to make informed decisions based on the best scientific evidence,” write Lin and Gostin.

With that they’re just getting warmed up.

“Congress’s paternalistic response to USPSTF mammography screening recommendations vividly illuminates the social costs of politically mandated care,” write Lin and Gostin. “Rather than benefiting women, political interference with science can discourage shared decision making, increase harms from screening and foster public doubt about the value and integrity of science.”

JAMA has posted the piece in full for free. Read it here.