HRSA Requests Comments on Draft Breast Cancer Screening Recommendations

The Health Resources and Services Administration (HRSA) is requesting public comment on draft recommendations for HRSA-supported Women's Preventive Services Guidelines, including for breast cancer screening. Preventive services in the guidelines are required by the Affordable Care Act to be covered without cost-sharing by certain group health plans and health insurance issuers.

The current HRSA screening recommendation for women at average risk for breast cancer is:

“WPSI recommends that average-risk women initiate mammography screening no earlier than age 40 and no later than age 50. Screening mammography should occur at least biennially and as frequently as annually. Screening should continue through at least age 74 and age alone should not be the basis to discontinue screening. These screening recommendations are for women at average risk of breast cancer. Women at increased risk should also undergo periodic mammography screening, however, recommendations for additional services are beyond the scope of this recommendation.”

The draft update for public comment is:

“The Women's Preventive Services Initiative recommends that women at average-risk of breast cancer initiate mammography screening no earlier than age 40 and no later than age 50. Screening mammography should occur at least biennially and as frequently as annually. Women may require additional imaging to complete the screening process or to address findings on the initial screening mammography. If additional imaging (e.g., MRI, ultrasound, mammography) and pathology exams are indicated, those services are also recommended to complete the screening process for malignancies. Screening should continue through at least age 74 and age alone should not be the basis to discontinue screening.  Women at increased risk should also undergo periodic mammography screening, however, recommendations for additional services are beyond the scope of this recommendation.”

HRSA’s justification noted that, per registry data reviewed by the agency’s advisors, roughly 10% of women needed additional imaging to differentiate abnormal findings, such as special mammography views, ultrasound or MRI. HRSA also proposed a new guideline for “Patient Navigation for Breast and Cervical Cancer Screening” to provide access as needed to individualized navigation services.

The American College of Radiology® (ACR®) is collecting member input for potential inclusion in future ACR comments to HRSA.  For questions on this topic, or to provide technical feedback, contact Michael Peters, ACR Senior Director, Government Affairs, or Katie Grady, Government Affairs Director.