Some U.S. states have begun using controversial new breast cancer screening guidelines to stop offering routine mammograms for uninsured women in their 40s, a survey by the Avon Foundation for Women released on Monday found.
The Avon survey of more than 150 breast cancer health educators and providers from 48 states and Washington, D.C. found a quarter of the states have either cut or eliminated screening mammography and other early detection services for women under 50.
The survey renewed concerns that the guidelines from the U.S. Preventive Services Task Force, which raised the recommended age for women to start getting screened for breast cancer to 50, might be used to deny health coverage for women.
"Lawmakers at all levels need to act now to ensure that these recommendations do no further damage, and that women have full and ready access to mammography," Dr. James Thrall, chair of the American College of Radiology's Board of Chancellors, said in a statement.
Issued in November, the guidelines sparked an outcry from cancer doctors and advocacy groups who said the changes would mean more women would die from breast cancer, and from lawmakers who said they could be used to ration healthcare.
"Our survey gives us an early indication from those working on the front lines of breast cancer education, screening and treatment as to how the recommended guidelines may be affecting their work," said Marc Hurlbert, director of the Avon Foundation Breast Cancer Crusade, which is partly funded by Avon Products Inc.
The poll, conducted among the nonprofit foundation's grant recipients gathered at the group's annual breast cancer forum in San Francisco, was meant to get an early read on how states have responded to the guidelines, spokesman Mark Caffee said.
Survey respondents ranged from small community groups to leading cancer centers like Johns Hopkins University in Baltimore.
Respondents from Alaska, California, Florida, Illinois, Michigan, Mississippi, Missouri, Nebraska, New York and Washington, D.C., said they have seen changes in breast and cervical cancer early detection programs in which screening mammography and other early detection services had been cut back or eliminated for women under age 50.
The programs, funded by both state and federal dollars, offer low-income, uninsured, and underserved women access to breast and cervical cancer screening and diagnostic services.
In November, U.S. Health and Human Services Secretary Kathleen Sebelius said the U.S. Preventive Services Task Force did not set federal policy and its findings would not affect the services the government pays for.
The American College of Radiology, which rejected the task force guidelines, urged lawmakers to officially exclude the panel's recommendations from coverage decisions by federal and state insurance programs.
