Days after a controversial recommendation from the US Preventive Services Task Force on breast cancer screening, a separate organization has recommended less screenings for cervical cancer. Anyone seeing eerie parallels or ready to scream about “rationing” needs to read a bit more closely:
New guidelines for cervical cancer screening say women should delay their first Pap test until age 21, and be screened less often than recommended in the past.
The advice, from the American College of Obstetricians and Gynecologists, is meant to decrease unnecessary testing and potentially harmful treatment, particularly in teenagers and young women. The group’s previous guidelines had recommended yearly testing for young women, starting within three years of their first sexual intercourse, but no later than age 21.
Arriving on the heels of hotly disputed guidelines calling for less use of mammography, the new recommendations might seem like part of a larger plan to slash cancer screening for women. But the timing was coincidental, said Dr. Cheryl B. Iglesia, the chairwoman of a panel in the obstetricians’ group that developed the Pap smear guidelines. The group updates its advice regularly based on new medical information, and Dr. Iglesia said the latest recommendations had been in the works for several years, “long before the Obama health plan came into existence.”
She called the timing crazy, uncanny and “an unfortunate perfect storm,” adding, “There’s no political agenda with regard to these recommendations.”
I would argue that there would be a political agenda if these recommendations were somehow muzzled until after the health care bill was dispensed with. The fact that they’re coming out at this sensitive moment would be the opposite of how any good plotter would act. In the case of the USPSTF, they operate independently of the Dept. of Health and Human Services and were stunned by the reaction to their report.
Further, the American College of Obstetricians and Gynecologists has absolutely no role in the health care bill whatsoever, and they don’t agree with the USPSTF recommendation on mammograms. They find that there are more potential pitfalls to overscreening on pap smears than on mammograms. In addition, the findings of either group are not binding on doctors or patients; as the Health and Human Services Secretary made abundantly clear the other day, even the USPSTF recommendations are little more than advisory – though I still maintain they may effect cost sharing gudelines.
Preliminary reports show that insurance companies will continue to pay for mammograms starting at age 40. They have little ability not to – the procedure is mandated at that age in 49 of the 50 states. Changing the guidelines would involve changing all those state laws. There has been no comment from insurers yet about the cervical cancer guidelines.