Spending Bill May Interfere With Evidence-Based Mammagrapy Recommendations

Researchers warn political interference may discourage shared decision-making in breast cancer treatment.

In the wake of the recently passed congressional spending bill, 2 university professors believe the legislation undermines both the science and health of women with breast cancer.

The FY 2016 Consolidated Appropriations Act (HR 2019) that passed in December requires private insurers to follow scientific guidance for breast cancer screening coverage.

According to an article that was published in Jama, 2 Georgetown University professors noted the recommendations of the United States Preventive Services Task Force for private insurers is no longer relevant.

“Outdated public health guidance, it was making a scientific judgment for which it is distinctly unqualified," the researchers wrote.

Previously, mammography screenings were recommended for women starting at age 40, every 1 to 2 years. However, private insurers are required to follow the task force recommendations under the Affordable Care Act (ACA), which states that the screenings should now be done every other year for average-risk women at 50-years and older.

There has been nothing reported for women who are younger than 50 years.

The issue with the new bill is the wording allows the ACA to override the mammography recommendations. Before the ACA was put in place, insurers were able to decide which screenings, counseling, and vaccinations they wanted to cover.

However, under the act, insurers give cost-free access to preventive services determined by the task force.

"The task force reviewed thousands of research studies over the past decade,” said Georgetown Professor Lawrence Gostin, JD. “Yet legislators with no medical or scientific education decided that the rigorous work carried out by the task force was all wrong, and that they have better advice for women. Congress is sowing public distrust in the integrity of science.”

The researchers stated that legislators were overreaching by interfering with what should be scientific-based recommendations.

"By insisting on referring to the 2002 recommendations, Congress is in fact making a scientific judgment," adds Kenneth Lin, MD, MPH. "This action strikes at the task force's credibility by saying it was right 2002, but was wrong in 2009, and is wrong now."

The professors went on to say how important it is for women make decisions based on data and scientific evidence, as opposed to legislation.

"The public's health is best served when women's personal decisions about screening are informed by evidence rather than political considerations," the researchers wrote. "Rather than benefiting women, political interference with science can discourage shared decision-making, increase harms from screening, and foster public doubt about the value and integrity of science."