By: Amy Lotven (email@example.com)
Breast cancer advocates and a bipartisan group of lawmakers Friday (July 23) held a congressional briefing to rally support for bipartisan legislation that would protect annual cost-free breast cancer screenings for women aged 40 and older.
The Affordable Care Act requires plans to cover all preventive screenings that have an A or B grade from the United States Preventive Services Task Force (USPSTF), which for years included annual cancer screenings for women aged 40-75. In 2009, however, USPSTF updated its guidance, giving a “C” grade to screenings for woman 40-49, and a “B” grade for biennial, rather than annual, exams for women 50-74. In 2010, Congress banned the guidance from going into effect, and re-upped the ban in 2015, after USPSTF issued another round of draft recommendations that mirrored the 2009 guidance.
Without congressional action, that guidance would go into effect in January 2023.
The Protecting Access to Lifesaving Screening (PALS) Act, re-introduced last week in the House and Senate, would extend the moratorium through 2028. Stakeholders at the briefing said the USPSTF guidance falls short because it ignores evidence that some non-white populations are more likely to get breast cancer at a younger age.
Linda Goler Blount, president and CEO of Black Women’s Health Imperative, stressed that Black women die from breast cancer at a 42% higher rate than white women. A key reason for the discrepancy is because Black women often get cancer five to seven years younger than white women, and so it is detected at a later stage. Black women are also less likely to have access to the latest technologies for treatment. Such barriers to care are particularly hard to hear when there’s a 100% survival rate when the cancer is caught and treated early, she said.
The USPSTF says its recommendations are based in science, Blount said, and it’s true that the panel reviewed data from thousands of women, she adds. But they were from Canada and Sweden, so the data failed to account for the more diverse population in America.
Elena Rios, president and CEO of the National Hispanic Medical Association, noted breast cancer is the most common cancer among Hispanic women and men, and it is more likely to be caught at a later stage in these populations.
The advocates said that removing barriers to cancer treatment is especially important since so many people skipped annual screenings during the pandemic.
On June 30, the Centers for Disease Control and Prevention released a report finding that the number of cancer screening tests provided through the CDC’s National Breast and Cervical Cancer Early Detection Program fell by 87% for breast cancer in April 2020, compared with the previous 5-year averages for that month. “Declines in breast cancer screening varied from 84% percent among Hispanic women to 98% among American Indian/Alaskan Native women,” the study found. CDC says the volume of tests began to recover in May and by June breast cancer screenings were still about 39% below the five-year averages for that month.
Carolyn Aldigé Founder and CEO of the Prevent Cancer Foundation also pointed out that while at the beginning of the pandemic the screenings dropped because doctors’ offices were closed, many people still stayed away once they reopened, and rates still haven’t returned to normal. This will result in more late-stage diagnoses and preventable deaths, she said, pointing out that National Cancer Institute Director Ned Sharpless has predicted the pandemic will result in 10,000 excess deaths from breast and colorectal cancer over the next 10 years.
In May 2020, the Prevent Cancer Foundation launched a campaign to counter the declines by stressing the importance of screenings and helping with appointment reminds. But she noted, these efforts are for naught if people do not have access to cost-free screenings.
Rep. Debbie Wasserman Schultz (D-FL) introduced the PALS Act with GOP Rep. Fred Upton (MI) and said during the briefing that she will continue to champion its passage. The bill extends moratorium on USPTFs” misguided” recommendations and guarantees cost-free screenings for about 20 million people who would otherwise be at risk, she said.
Sen. Marsha Blackburn (R-TN) and Sen. Dianne Feinstein (D-CA) sponsored the Senate’s sister bill.