New government guidelines that say women shouldn’t bother to do breast self-exams and that they should put off mammograms until they turn 50 seem, at best, confusing and, at worst, an attempt to cut health care costs in a decidedly unhealthy way.

For years the U.S. Preventative Services Task Force has recommended routine mammograms for women 40 and older.
Now, the task force has concluded in a report released Monday that women who aren’t seen as high-risk for breast cancer don’t really need to bother with those uncomfortable tests until they turn 50, at which time they should have the tests done biannually. After a woman turns 75, the task force says the benefits are unknown. Meanwhile, the task force has determined that breast exams performed by doctors have undetermined value and that self-exams are of no value at all.

According to the task force’s research, a woman older than 40 has a 3 percent probability of dying of breast cancer, and a mammogram every other year would cut their risk by 16 percent, saving the lives of five women 50 and older out of every 1,000 screened.

Starting mammograms at age 40, however, would save only one additional life out of 1,000, while leading to 470 false alarms. Continuing mammograms after age 79 would save three lives out of 1,000, but Georgetown University researcher Dr. Jeanne Mandelblatt says that is diagnosing tumors in women destined to die from something else.

The government panel of doctors and scientists concluded that too many false alarms and unneeded biopsies prompted by the mammograms while not substantially improving women’s odds of survival simply aren’t worth it. “The benefits are less and the harms are greater when screening starts in the 40s,” Dr. Diana Petitti, vice chair of the panel, told The Associated Press.

That’s a clinical way of saying that saving just one life out of 1,000 isn’t worth the trouble and expense.

And no doubt, the false positives do cause worry and concern. To that, we would say that continued research is needed to better perfect the detection system.

But when it comes to women’s health, we also side with the American Cancer Society, which arrived at a much different conclusion than the government panel did. The Cancer Society is sticking by its recommendations that all women have annual mammograms and clinical breast exams once they reach the age of 40.

“With its new recommendations, the USPSTF is essentially telling women that mammography at age 40 to 49 saves lives, just not enough of them,” Dr. Otis W. Brawley, chief medical officer of the Cancer Society, said. “The task force says screening women in their 40s would reduce their risk of death from breast cancer by 15 percent, just as it does for women in their 50s. But because women in their 40s are at lower risk of the disease than women 50 and above, the USPSTF says the actual number of lives saved is not enough to recommend widespread screening.

“The most recent data show us that approximately 17 percent of breast cancer deaths occurred in women who were diagnosed in their 40s, and 22 percent occurred in women diagnosed in their 50s. Breast cancer is a serious health problem facing adult women, and mammography is part of our solution beginning at age 40 for average risk women.”

A cynical reading of the recommendation might conclude that the government panel wasn’t looking to have the best interest of woman at heart, but was trying to find ways to cut medical testing expenses as cost-sensitive health care insurance reform progresses through Congress.

Insurance industry officials say the task force recommendations won’t influence what they will or won’t cover, but if the government does establish minimum health care standards that private insurers will have to meet, what incentive would private insurers have to go beyond that minimum? And where would the government turn to establish its minimum standards for mammography? Its own task force or the American Cancer Society?

We agree with the Cancer Society: Saving one life is a valuable, worthwhile enterprise.