Is it politically motivated?

I don't believe the initial  report was  politically motivated but do think it will have political ramifications due to the widespread media coverage.  It is an issue that insurance carriers would benefit from.  Could someone explain to me why the report also discouraged us from breast self-examination? 

Using the old "If they can send a man to the moon, why can't they (fill in the blank)", maybe this report could be the impetus to actually devise a much more effective, much safer screening tool.

I too wonder why BSE is being discouraged.  Can't find the explanation for that, yet.....

 Politically motivated?  I believe the insurance companies are getting worried about health care reform - so, if you think it's political, well, I think it's connected.  I think it's a ploy so people can say "I told you so" and bash health care reform, which has turned into a political fight.  Heaven help those who cannot afford preventative care. 

Question - why not do BSE's?  If you tell people BSE's aren't effective, they won't do them.  If they don't do them, they won't find anything wrong.  If they don't find anything wrong, they won't go and get tested, so the insurance companines won't have to pay for anything.  That's what it looks like to me.  It's all in the bottom dollar, and IMHO, the insurance companies have a huge hand in this.  They don't want to pay for prevention, or worse.  We are slipping back into the dark ages aren't we.  And this comes from "doctors" who aren't even close to being specialists in the BC area.  What a crock. 

I went to Susan Love's web site and read some of the comments people have written. I can't believe Avon is partnered with Dr. Love and her million women campaign. I wonder where Avon stands on all of this?

I am horrified by these new guidelines. I would be dead if I would have waited for my two year mammogram...

Linda

The membership of the Task Force changes by one-fourth every year.

New appointees take their seats in January.

Three new appointees took their seats on January 10, 2009 (appointed before the Obama administration began) and were not among the authors of the guidelines (Susan Curry, Joy Melnikow, Wanda Nicholson).

The authors of the 2009 guidelines (released yesterday) took their seats between January 2005 and January 2008.  (The authors of the 2002 guidelines were all different, and took their seats between January 1998 and January 2001.)

Panel members appointed during the current administration will begin their appointments in January 2010.

Note: these appointments, as far as I know, are made by the AHRQ/DHHS and not by any administration in office.
http://www.ahrq.gov/clinic/uspstfab.htm
http://edocket.access.gpo.gov/2008/E8-11191.htm

The really outrageous thing, to me, is that "The U.S. Preventive Services Task Force (USPSTF) consists of experts in primary care, epidemiology, and prevention. Members come from the specialties of family medicine, pediatrics, internal medicine, obstetrics and gynecology, geriatrics, preventive medicine, public health, behavioral medicine, and nursing" -- and is charged with making recommendations about breast cancer screening.

(from FAQ on the AHRQ website)

 Hello Ladies,

This is such a powerful topic. Thank you for your wizened comments. I too would have been missed in a scan pickup diagnosis under 50 if the proposed recommendations were implemented. 

 Everything is timed, and since AHRQ is a government entity I would say the US Prevention Task Force Committee's most recent mammogram recommendation was well considered prior to it's publication. Here is what the AHRQ says about itself and it's mission. AHRQ clearly states it's a best medical evidence research arm of the US Government. 

http://www.ahrq.gov/about/whatis.htm

http://www.ahrq.gov

The publication of the US Prevention Task Force Recommendations limiting mammogram to 50 and above and then also, to every two years is shockingly clear in its intent to ration medicine by allowing that actually fairly large 3% number (in real people terms) of women and men be intentionally  overlooked,or forsaken, for cost savings reasons. Shocking! I pity the 3% who would be found with later stage cancer and go on to die from this dastard disease, and like you will fight this.

Just my opinion, taken from what I've read, heard and seen during the Health Care debate, including during the President's Speech to Congress on Health Care Reform, these best evidence plans are what the government has in mind to keep costs down (also for Medicare and Medicaid patients but that's a different topic). However, for breast cancer screening I assumed cost savings would be implement by insisting physicians follow well thought out and comprehensive diagnostic and treatment breast cancer guidelines like NCCN (National Coalition of Cancer Networks) NOT the highly controversial US Prevention Task Force Recommendations which as one poster mentioned doesn't even have an oncologist or surgeon on the force.

 Nothing is without intent, and I ponder if this may be a way to squirrel the effort against health insurance reform right now, given the state of US affairs. Perhaps second thoughts have surfaced that it's too much of a fight, not enough in return, and therefore controversial decisions which manifest as health care rationing are being put forth to stymie a Congressional bill and Presidential signature. Already Big Pharma is raising name brand drugs, in an attempt to offset their $80 billion dollar pledge, and so may be insurers with premiums. Thus our Government may have concluded to pull the plug on health care reform, especially in light of continuing big financial demands such as the wars, unemployment etc.

 These are disconcerting times in America, yet to see nefarious health care actions and counter actions play out so openly is probably better so we all wake up. At issue is the future of American health care as a right, as affordable and as humanely applied in best evidence decisions.

Withholding life saving mammograms and scanning studies which further ensue from mammograms' findings is clearly NOT in our countries best interests nor acceptable. We don't go one step forward and two or three steps backwards in American cancer medicine; never have, never will and I don't believe such will be tolerated.

Best to get to our pens and start writing our Congress and President, as well as to open our wallets which we keep ever more close in life from fiscal necessity.

One final thought: be wary of middle of the night final Health Care Bill insertions if a Bill does reach finality. The powers that be in Congress, with some higher power and deeper pocket urgings, have now resorted to potentially devastating and widely impacting bill insertions in the wee hours of the morning to get unpopular legislation written. Like a thief in the night..... So incredibly un-American and so very, very sad.

This is my personal opinion obviously, yet one based on much reading and contemplating. Good luck to us all, to the future of American medicine, and to our children and future generations.

Tender

So scary.  I am sitting here thinking of my recent "fights" with my surgeons regarding mastectomy v no mastectomy in Stage IV BC.  This conversation will take us to a new level - very sad and depressing.....

okay ladies - I never had an abortion, used BC pills for a very short time (shorter than any of my friends - 5 years tops) and self exam (and doctors exam) did not find my tumor.  Mammogram (and ultrasound and MRI) did.  We need some kind of screening prior to age 50. 

I do not have family history, etc. etc.   Like some of you have said, I am hoping this leads to more ultrasounds and MRI's- not just a sit back and wait until we are 50.

Welcome to government healthcare. This is exactly what we will see. Bureaucrats that haven't seen a patient in years making decisions about our healthcare. It doesn't matter who appoints these people. These decisions are made on what is best for the majority not what is best for the individual. If a small percentage benefit then the cost doesn't justify the benefit.These recommendations are made from a public health perspective not a patient care perspective. Look at the guidelines for countries with government controlled healthcare. They will recommend screening every 2 or 3 years. They will also stop screening at a certain age like 75.

Get ready for cut off ages on cardiac bypass surgery, knee and hip replacements. If you think insurance companies are hard to deal with, wait until you have to deal with a government employee. To get a small taste of government health care go check out your county hospital emergency room or try to get your cancer treatments in their clinic system.

Madalyn,

Thank you for the link to the other recommendations given by this group.  I also have COPD and so I wanted to see what their screening recommendations were for it - they recommend NO spirometry screening for it, when according to the COPD Foundation and other COPD groups, the best way to detect COPD (emphysema and/or chronic bronchitis) is spirometry!!  Inexpensive spirometry machines in primary care physicians offices diagnose it quickly and before it gets more costly to treat.  My COPD wasn't diagnosed until I was referred to a pulmonary doctor who gave me a spirometry test.  So again, this group of doctors seem to have made a recommendation that makes no sense.

With COPD, as with breast cancer, early detection saves lives.

Edited to add:  Their recommendation for osteoporosis screening is:

The U.S. Preventive Services Task Force (USPSTF) recommends that women aged 65 and older be screened routinely for osteoporosis. The USPSTF recommends that routine screening begin at age 60 for women at increased risk for osteoporotic fractures. The USPSTF makes no recommendation for or against routine osteoporosis screening in postmenopausal women who are younger than 60 or in women aged 60-64 who are not at increased risk for osteoporotic fractures.

By the time I was in my early 50's I already had spinal compression fractures caused by osteoporosis.  Again, because of risk factors BEFORE age 50, I was getting dexa scans every year.

Hugs,

Karen 

I remember reading about this almost three years ago as I was being dx.  This is not a new theory.  There are many theories out there.  Regardless, the fact is, in our 'socialized' system (Cdn) we DO have mammos before 50.  And we DO have annual ones too.  The gov't health care proposal in America will not be profit driven.  The insurance companies are and always will be.  I definitely think that this was a well timed release and is getting the exact response that was hoped for.

PIP's right -- you want a mammo, you get a mammo.  You don't have to fight to get one, like it seems you might have to in the US in the future (or even now???).  When I was 39 or 40 my PCP said it was time to get a baseline mammo -- so I got one.  There wasn't a problem to investigate.

The craziest thing is to not teach BSEs -- if there won't be routine screening, it seems the time to promote BSEs!

Gee, tzus -- as a Canadian living in Canada when I got my baseline screening I have to disagree.  What's your experience in Canada?

And you base this on.....  Sorry 2tzus, you're wrong.  I don't understand why you don't believe the Canadian women who tell you otherwise.  What's your problem?

Edit:  I always required a piece of paper (doctor's order) to get a mammo or any test in the US.  I guess I had crappy insurance that I needed this from a doc before waltzing in to get one.