The American College of Radiology Reports Mammography Protections in Year-End Legislation Help Efforts to Address Breast Cancer Care Disparities

December 23,2020

The American College of Radiology, Society of Breast Imaging^®, patient advocates and others secured an extension of the moratorium on harmful 2009 and 2016 United States Preventive Services Task Force (USPSTF) Breast Cancer Screening Guidelines from Dec. 31, 2021 to Dec. 31, 2022.

The American College of Radiology notes without this added protection gained in the Consolidated Appropriations Act, 2021 (Omnibus and Coronavirus Relief Bill), under the Affordable Care Act (ACA), mammography coverage for women younger than 50 may have been impacted starting Jan. 1, 2022. The newly passed bill ensures that women ages 40 and older who want annual screening mammograms will retain insurance coverage with no copay.

The new legislation continues to recognize 2002 USPSTF guidelines for coverage decisions. The 2002 guidelines call for screening every one to two years starting at age 40 — rather than delayed and less frequent screening allowed under 2009/2016 USPSTF recommendations.

The Affordable Care Act (ACA) requires insurers to financially cover exams given a grade of “B” or higher by the USPSTF (with no patient cost-sharing). The USPSTF assigned routine screening of women ages 40–49 a “C” and gave a “B” grade only to every other year screening of women 50–74. Women 40–49 who want routine screening and those 50–74 who want annual rather than biennial screening would not have been guaranteed coverage after Jan. 1, 2022 without the moratorium extension.  

“We are grateful for the congressional champions who have worked tirelessly to extend the current moratorium on the ill-advised USPSTF recommendations. Loss of coverage for annual screening mammograms for women starting at age 40 would be devastating to the health of women. Loss of insurance coverage could have a particularly negative impact in underserved areas where screening is less frequent. We are glad that Congress acted to extend this coverage for women,” said Dana Smetherman, MD, Chair of the American College of Radiology (ACR) Breast Imaging Commission.

• African American women are 42% more likely to die from breast cancer than white women. In fact, since 1990, breast cancer death rates dropped 23% in African American women — compared to a 37% drop in whites. A higher proportion of non-white women are diagnosed with breast cancer before age 50 than white women.
• Women who live in rural areas are less likely to be screened and more likely to die of breast cancer than those who live in metropolitan areas. The breast cancer death rate is also declining more slowly in rural areas than in larger cities.

“Without the extension, and the financial coverage it ensures, many women may not be able to afford breast cancer screening. Undoubtedly, this would cause screening rates to drop, thousands more to die from the disease, and thousands more to endure more extensive and invasive treatment than if an annual mammogram had caught their cancer earlier,” said Jessica W.T. Leung, MD, FACR, FSBI, President of the Society of Breast Imaging.

Published analysis, using the task force’s 2009 methodology, showed that, if the 2009/2016 guidelines were used, approximately 6,500 additional women in the United States would die from breast cancer each year. Many more would experience more extensive and expensive treatments than if their cancers were identified earlier by routine mammography.

For more information regarding the proven effectiveness of regular mammography screening at reducing breast cancer deaths, please visit RadiologyInfo.org, MammographySavesLives.org and EndTheConfusion.org.