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Letter to Sylvia Matthews Burwell, Secretary of U.S. Department of Health and Human Services - Breast Cancer Prevention

Dear Secretary Burwell:

As strong supporters of women's health, we are committed to protecting access to breast cancer screening to minimize the impact of this deadly disease. According to National Cancer Institute data, the U.S. breast cancer death rate has dropped 35 percent since mammography screening became widespread in the mid-1980s.

On April 20, 2015 the United States Preventive Services Task Force (USPSTF) released draft recommendations proposing a major change in the approach to breast cancer screening. The USPSTF essentially re-stated their 2009 recommendation by assigning a "C" grade for biennial screening mammography for women ages 40 to 49, which can be interpreted as advising against screening in this age group and limit life-saving early detection. Additionally, the USPSTF proposed a "B" grade to only biennial screening mammography for women ages 50 to 74 years.

The 2009 recommendations received widespread criticism from patient advocates and medical experts, and organizations including the American Cancer Society (ACS), the American College of Radiology, and the American College of Obstetricians and Gynecologists went as far as to advise physicians and patients to ignore the recommendation. Subsequently, a provision was signed into law that was meant to prevent the 2009 USPSTF recommendation from going into effect.

If the draft recommendations which were released on April 20th are finalized, women ages 40 to 49 who choose routine screening, and those 50 to 74 who want to be screened annually may encounter issues finding an insurance plan which provides this level of coverage, or at the very least be forced to pay more for this added benefit. The impact of impaired access to breast cancer screening would affect all U.S. women, particularly those in underserved communities who are hardest hit by the disease.

In its explanation, the USPSTF concluded that "some women in their 40s will benefit from mammography… while others will be harmed." The panel said those hurt include the effect of exposure to radiation from multiple tests and the stress of over-diagnosis on the patient. This highlights the importance of individualized assessment of risk factors, and what a woman and her physician decide is the best screening option for her. Lack of coverage for mammograms as a screening tool could take away this choice from some patients for accessing the care they need. As Members of Congress concerned about the impact of breast cancer, we believe (and many experts agree) that delayed detection and treatment have a far worse outcome than the harm USPTSTF has laid out.

While we acknowledge these are draft, not final, recommendations, years of science and medicine have shown that appropriate screening can lead to early detection and save lives. We urge the USPSTF to take into consideration the benefits of prevention, keep in mind the thousands of women who are diagnosed with breast cancer in their 40s, and not jeopardize access to these screenings.


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