Monday, November 30, 2009

Conflicts galore among critics of new mammography guidelines

This Wednesday, the House Committee on Energy and Commerce will hold a hearing on the new breast cancer screening recommendations, in response no doubt to the storm of criticism that greeted the recent guidelines issued by the US Preventative Services Task Force. I just hope the committee (or rather its subcommittee on health) takes a close look not just at the task force, an independent panel appointed by the federal Agency for Healthcare Research and Quality, but at the myriad conflicts of interest among the loudest critics of its new recommendations.

As you'll recall, the Task Force concluded that routine screening mammograms for women 40-to-49 years old was not necessary, and called for screening every two years for women 50 to 74. So it comes as no surprise to learn that while Task Force members are specifically prohibited from having “substantial conflicts of interest," their critics are not similarly constrained. Many of the most vociferous critics of the new screening guidelines either stand to benefit directly from rolling back the new guidelines or belong to organizations with financial ties to companies that do, according to an article published in Bioethics Forum. As Adrianne Fugh-Berman and Alicia Bell point out in this article, key critics quoted in the press in recent weeks are either professors with patents to breast imaging devices or stock in companies that make them (academics like Daniel Kopans and Robert Schmidt), or they are top officers at organizations like the American College of Radiology and the American Cancer Society, which receive substantial funding from the makers of mammography machines, including Johnson & Johnson, Siemens and Hologic.

The press, by and large, has done a lousy job of highlighting these conflicts of interest and the greed-ridden agendas behind much of the criticism. And as Gary Schwitzer notes, media coverage of the new guidelines has also been less than objective and fully informed; to my mind, Fugh-Berman and Bell do a much better job of capsuling the reasoning behind the Task Force's long-considered recommendations.

So I can only hope at its hearing on Wednesday, the House Committee on Energy and Commerce fully explores the issue of just whose ox is being gored by the new screening recommendations. I also hope the reporters covering the hearing do their homework and check not only the financial ties of the speakers but of the Congressional committee members themselves. This wouldn't be the first time that grandstanding legislators turn out to be the recipients of largesse from the very industries they wax so eloquently in defense of.

Hat tip to gooznews for alerting me to Wednesday's hearing.

3 comments:

Michael Kirsch, M.D. said...

Nice post, Alison. The mammo-mania debacle showed us how difficult health care reform will be. Here we saw the USPSTF, a non-partisan organization known for its objectivity - being trashed in the public square by various groups riddled with conflicts of interest. It was shameful that the Secretary of Health and Human Services threw her own USPSTF task force into the wood chipper. Evidence-Based Medicine R.I.P. More thoughts at http://bit.ly/656CwP

Kris said...

I look forward to reading more on the topic in the future. Keep up the good work! This blog is going to be great resource. Love reading it.

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