John Goodman's Health Policy Blog, November 23, 2009

Having barely digested the U.S. Preventive Services Task Forces’ suggestion that women between 40 and 50 years of age don’t need mammograms, American women now have to deal with the American College of Obstetricians & Gynecologists’ recommendation that they don’t need Pap smears until they turn 21.  But at least ACOG resisted the USPSTF’s recommendation to delay mammograms until age 50!

Other well-informed observers (including Linda Gorman and the Wall Street Journal) saw the recommendation to reduce mammography as a harbinger of rationing to come under ObamaCare.  It didn’t take long for the counter-attack: The New York Times’ Kevin Sacks “reported” that “the backers of science-driven medicine….. have cheered the elevation of data in the setting of standards,” and the editorial board sternly warns us that the new recommendation is a guideline, and that it should not figure in the debate on health care.  Right: A federal task force issues recommendations contrary to those of the American Cancer Society and other medical groups, and we’re not supposed to worry that once the federal government takes over everyone’s access to health insurance, it’s preferences won’t prevail?

The New York Times also ran an op-ed by Dr. Robert Aronowitz, who proclaimed that American women and their physicians are “addicted to mammograms”!  Dr. Aronowitz traces the source of this “addiction” back to the 1870s, and notes that breast-cancer mortality barely budged from 1950 to 1990.  That’s an interesting stop-point.  According to the American Cancer Society (p. 8), significant declines in breast-cancer mortality occurred after 1990, and it mostly happened in younger women – the ones that the USPSTF doesn’t want screened anymore.

Dr. Aronowitz comes close to suggesting that our modern understanding of breast cancer is the result of a 19^th century patriarchal power structure of which we should be rid.  What’s next, will the New York Times run an op-ed by a post-modernist philosopher arguing that breast cancer is a “social construct,” like gender itself?