A federal mandate that requires insurers to cover annual screening mammograms for women 40 years and older is due to end on December 31, 2017. Patient and medical groups are concerned that this could have devastating consequences.
"Long-term, mammography will be less accessible for many women, especially younger women, which will result in unnecessary deaths from breast cancer," Dr. Debra Monticciolo, chair of the American College of Radiology Breast Imaging Commission, told HCB News. "The greatest number of years of life lost to breast cancer occurs among women 40-49 years old. We will lose the significant gains that we've made against breast cancer."
The ACA requires private insurers to cover procedures that the U.S. Preventive Services Task Force (USPSTF) grades an "A" or "B" with no copay. The Task Force graded routine screening of women ages 40 to 49 a "C" and biennial screening for women between ages 50 and 74 a "B".
The federal statute bans insurers from basing coverage decisions on the current USPSTF breast cancer screening recommendations. Instead, it encourages insurers to consider 2002 USPSTF recommendations for regular screening in women 40 and older.
An extension of this mandate is included in larger appropriations legislation under consideration on Capitol Hill. The patient and medical group want Congress to ensure that it’s included in the final version of this legislation.
The American Congress of Obstetricians and Gynecologists, National Comprehensive Cancer Network, Society of Breast Imaging (SBI) and ACR recommend that women undergo annual mammograms starting at the age of 40. The USPSTF and American Cancer Society agree that the most lives are saved when that’s the case.
Women in their 40s typically have dense breasts, which raises the likelihood of them developing breast cancer, according to JoAnn Pushkin, executive director of DenseBreast-info.org. Annual screening with mammography cuts a woman’s risk of dying from breast cancer by almost half, said Dr. Elizabeth Morris, president of SBI.
Data from the National Cancer Institute found that the rate of breast cancer deaths in the U.S. didn’t change in the 50 years before mammography screening became widespread in the mid-1980s. But once it was implemented, the rate dropped by over a third.
