For years, American women have depended on medical guidelines that call for yearly exams for breast and cervical cancer. But recently, two panels of experts changed the recommendations when women should first undergo these screenings, and whether they are needed every year. Now some doctors are asking if these changes are just the beginning of rationed health care for all.
For decades, American women considered mammograms part of their yearly physical exam. Now one medical panel has upset that routine, and many doctors are angry.
"I'm saying very powerfully ignore them, because unequivocally, and they agreed with this, this will increase the number of women dying of breast cancer," said Dr. Bernadine Healy, the former director of the National Institutes of Health.
Women in their 40's are now being told they can delay their first mammogram until age 50, and after 50, they can postpone that screening until every other year.
"This study is absolutely ludicrous. They need to start getting mammograms at age 40. Mammograms pick up cancers when they're smaller," said Dr. Sharon Rosenbaum Smith with St. Luke's Roosevelt Hospital.
The U.S. Preventive Services Task Force says it issued the relaxed guidelines for breast cancer screening because of fears of unnecessary radiation, painful biopsies and needless testing.
Breast cancer researcher Susan Love is just as outspoken in defense of the new guidelines. "The issue is not depriving young women of their God-given right to be radiated. It's really, let's not give them radiation if it's not really helping them," she said.
Shortly after the new guidelines were released, there were some reports of women canceling mammograms and even cancer surgery because of the news.
Health and Human Services Secretary Kathleen Sebelius advised patients to stay calm. "Do what you've always done. Talk to your doctor. Figure out your own health situation with your doctor, your family history. Those are the really important ingredients," she said.
To add to the confusion, the American College of Obstetricians and Gynecologists changed its recommendations for the first cervical cancer screening for young women. These women can now delay their first test, known as the Pap Smear, until age 21.
The previous guideline called for this test at the age of 18, or at the start of earlier sexual activity.
According to the new recommendations, older women in their 30's and beyond can be screened every three years unless tests reveal an abnormality.
Dr. Robert Smith of the American Cancer Society says these are sensible guidelines. "We can actually observe the precursor 'lesions' associated with cervical cancer for a period of 10 to 20 years. They're very, very slow growing," she said.
The timing of the new recommendations for cervical and breast cancer screenings has upset doctors, like radiologist Peter Jokich of Rush University Medical Center, who say it is all linked to the congressional debate on health care reform. "It's about the beginning of rationing care. And I don't think it's about the health of the individual woman," he said.