Video: Sebelius: ‘Keep doing what you’ve been doing’

  1. Closed captioning of: Sebelius: ‘Keep doing what you’ve been doing’

    >>> but we're going to begin with new controversy over those controversial breast cancer screening guidelines. on wednesday, health and human services secretary kathleen sebelius released a statement telling women to "keep doing what you have been doing for years -- talk to your doctor about your individual history, ask questions and make the decision that is right for you." a short time later, sebelius talked to ann curry , and ann asked her if she was advising people to ignore the new recommendations.

    >> i'm telling women to take a look at the recommendations of the panel, which are, you know, looking globally at tens of thousands of cases, but then take that information and have a conversation with your doctor.

    >> are you saying that women should still consider having mammograms beginning at age 40?

    >> absolutely, based on their health history and their physician's recommendation.

    >> some people are saying that your response to the panel's recommendations are essentially throwing this panel under the bus. your reaction to that?

    >> they routinely update various recommendations. the last time they updated guidelines dealing with breast cancer was 2002 . they'll continue to do this, but they make recommendations looking at a global set of data. what is important then is to take those recommendations and put them in a real health care setting with real patients, and every patient is different, every woman is different.

    >> and let's bring in nbc's chief medical editor, dr. nancy snyderman . good morning to you.

    >> hi, meredith.

    >> i felt like the secretary did not directly answer ann's question, so let me ask you directly, was the task force thrown under a bus?

    >> yes. these are independent researchers, doctors, scientists from across the country who have been appointed with the task of looking at the hard science , then giving the government and industry recommendations, and they did that on monday. what we as a population were unwilling to accept, which has become very apparent over the last 48 hours , is we didn't like the message, that message being that mammography screening for women in that 40th -- between 40 and 49, is not necessarily cost-effective. i want to say, the scientists didn't even look at the cost. they said you know, the yield is not very good, it's not a good screening tool. and when she said yesterday, the message is simple -- we know it wasn't -- just keep doing what you've been doing, that's not what the recommendations were. so yes, i believe she was throwing them under the bus.

    >> do you think she was unduly influenced by the emotion of the moment or the politics behind it? a lot of people on the republican side are saying, see, this is the slippery slope we talk about. this is rationing starting.

    >> we'd be foolish not to use the word rationing, but the question is, is it smart rationing? should we spend money and do the right screening tests? but rationing wasn't part of the original task force . it was to advise people about guidelines. this is a task force that has advised this government in the past. it has advised on mammography, prostate cancer screening , lung cancer screening, bladder, even when to do genetic testing for breast cancer . but we know that, as you and i have talked about over the last 48 hours , emotion, antidote, lobbying, advocacy groups, doctors and patients have all weighed in, and i think what you've seen is a political reversal.

    >> but you can't get away from the fact that a lot of women believe that, you know, that they were save ed because of a mammogram.

    >> i recognize that.

    >> and if it's one woman out of 1,900 that's saved, every woman will say, that might be me.

    >> i understand that, too. and this is the role of scientists, to take the emotion out of the science and to look at the science. that was their charge. they are supposed to look at the hard numbers and then give recommendations back. antidotes matter, but so does hard science , and that was their mandate.

    >> well, i think what matt said earlier is true. i think women are as confused as they've ever been by this.

    >> yes. i think kathleen sebelius helped unroll that confusion message straight forward into today.

    >> dr. nancy, thank you so much.

updated 11/19/2009 3:08:50 PM ET 2009-11-19T20:08:50

A member of the independent panel whose new mammogram recommendations have led to confusion defended the task force's report, saying Thursday that it was based on the most up-to-date, accurate information available.

Dr. Timothy Wilt, a member of the U.S. Preventive Services Task Force, stuck by its recommendation that most women don't need mammograms in their 40s and should get one every two years starting at 50. The American Cancer Society's long-standing position has been that women should get annual cancer-screening mammograms starting at age 40.

The panel's recommendations "were based on the most rigorous peer review of up-to-date, accurate information about the evidence about the harms and benefits of treatment," Wilt said on ABC's "Good Morning America."

On Wednesday, Health and Human Services Secretary Kathleen Sebelius tried to ease the furor that has erupted since the panel issued its recommendations Monday. She said the task force does "not set federal policy and they don't determine what services are covered by the federal government." She advised women to "keep doing what you've been doing for years — talk to your doctor about your individual history, ask questions, and make the decision that is right for you."

Wilt did not take issue with Sebelius' statement. "Our recommendations support an individualized decision-making process," he said, and each woman still needs to talk with her doctor to make the most informed decision.

Video: More mixed messages on mammograms

The recommendations from the task force have left women confused about whose advice to follow. And opponents of changing health care policy have criticized the new recommendations as an example of what could be expected from government-managed care.

Wilt denied accusations that the recommendations were made to help the government spend less on mammograms.

"Costs are not considered at all," he said.

The panel of doctors and scientists concluded that such early and frequent screenings often lead to false alarms and unneeded biopsies, without substantially improving odds of survival for women under 50.



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