ASSEMBLY RESOLUTION No. 166
STATE OF NEW JERSEY
INTRODUCED JUNE 5, 1997
By Assemblywomen HECK, VANDERVALK, Murphy, Assemblyman Jones, Assemblywoman Quigley,
Assemblyman Felice and Assemblywoman Weinberg
An Assembly Resolution memorializing the President and Congress of the United States concerning recommendations to support and strengthen breast cancer screening efforts.
Whereas, On Mrch 27, 1997, the National Cancer Institute issued a joint statement of agreement with the American Cancer Society that "mammography screening of women in their 40's is beneficial and supportable with the current evidence;" however, unlike the American Cancer Society, the National Cancer Institute has not adopted a policy which recommends that women in their 40's receive an annual mammography screening; and
Whereas, Since 1993, the National Cancer Institute had maintained a policy of not recommending universal breast cancer screening for mammography beginning at age 40, based upon a perceived lack of clear scientific evidence for a reduction in deaths among women in their 40's; and this policy had been reaffirmed by the majority statement issued by the panel convened by the National Institutes of Health (NIH) Consensus Development Conference on Breast Cancer Screening for Women Ages 40-49 in January 1997, which found that the data on randomized controlled trials presented at the conference did not warrant a single recommendation for mammography screening for all women in their 40's and that each woman should decide for herself, in consultation with a health care professional, whether to undergo mammography; and
Whereas, The position taken by the NIH consensus development panel to eschew any recommendation for women to begin receiving mammography screening by age 40 was flatly rejected by a wide and impressive array of organizations, including: the American Academy of Family Physicians, the American Association of Women Radiologists, the American Cancer Society, the American College of Radiology, the American Medical Association, the American Osteopathic College of Radiology, the American Society for Therapeutic Radiology and Oncology, the American Society of Clinical Oncology, the American Society of Internal Medicine, the College of American Pathologists, and the National Medical Association, as well as a minority report issued by dissenting members of the NIH consensus development panel; and
Whereas, The very same statement issued by the above panel which declined to recommend mammograms for women in their 40's explicitly acknowledged that breast cancer is the single leading cause of death among women ages 40-49 in the United States, and that the incidence of breast cancer approximately doubles from ages 40 to 49; and
Whereas, More than 30,000 women in the United States ages 40 to 49 are diagnosed with breast cancer each year; and, according to a recent statement issued by the American College of Radiology, two independent studies from Sweden found a statistically significant decrease in the breast cancer death rate of 44% and 36%, respectively, for women who began mammography screening in their 40's; and
Whereas, In addition to the potential for saving lives, detecting breast cancer at an early stage can give a patient more choice in selecting among various treatment options, e.g., more women with cancer detected by mammography have the option of lumpectomy, rather than mastectomy, compared with women whose cancers were detected by palpation; and
Whereas, Initiating mammography screening at age 40 might increase screening compliance in later years, since screening at an early age could provide an opportunity for early patient education and increased awareness of, access to, and utilization of health care; and
Whereas, Current mammographic technology has improved from that used in the randomized controlled trials that were initiated between 1963 and 1982, which served as the basis for the NIH consensus development panel's conclusions, thereby putting in question the relevance of these research data with respect to the medical value of mammograms for women ages 40 to 49 today; and
Whereas, A joint public hearing conducted by the Assembly Policy and Regulatory Oversight Committee and the Assembly Health Committee on March 21, 1997 to discuss the NIH consensus development panel's conclusions found widespread support for mammography screening of women in their 40's from representatives of: the American Cancer Society-New Jersey Division, Inc., the American College of Radiology, the Medical Society of New Jersey, the New Jersey Association of Osteopathic Physicians and Surgeons, the University of Pennsylvania Medical Center, the Cancer Institute of New Jersey, the UMDNJ/University Hospital, Cooper Hospital/University Medical Center, Newark Beth Israel Medical Center, Englewood Hospital, the UMDNJ-New Jersey Medical School, Monmouth Medical Center, Somerset Medical Center, the Radiology Group of New Brunswick, the New Jersey Health Officers Association, the New Jersey Breast and Cervical Cancer Control Initiative in the Department of Health and Senior Services, the Commission on Cancer Research, the Division on Women in the Department of Community Affairs, and the Camden County Department of Health and Human Services, as well as the New Brunswick Area Senior Medical Director for the Bristol-Myers Squibb Company Pharmaceutical Group and members of the general public; and
Whereas, The Board of Directors of the American Cancer Society, on March 21, 1997, voted to incorporate within its guidelines a recommendation that women begin annual mammography screening at age 40; and
Whereas, The established medical need for annual mammography screening extends beyond women ages 40 to 49 all the way to those who are senior citizens, who are most at risk of developing breast cancer; however, the federal Medicare program currently will only cover a mammogram every two years; and
Whereas, The members of this House believe it would be a tragic mistake, the consequences of which may be measured in the lives of younger, middle-aged and older women, to continue current federal government policy regarding the lack of official support by the National Cancer Institute for a recommendation that women ages 40 to 49 receive an annual mammography screening and the failure of the Medicare program to cover annual mammograms for its women beneficiaries; now, therefore,
Be It Resolved by the General Assembly of the State of New Jersey:
1. This House memorializes the President and the Congress of the United States to endorse and seek to implement changes in current federal government policy, as well as the National Cancer Institute to revise its position, regarding the need for women ages 40 to 49 to receive an annual mammography screening in accordance with the guidelines of the American Cancer Society, and to ensure that the Medicare program covers annual mammograms for its women beneficiaries.
2. A duly authenticated copy of this resolution, signed by the Speaker of the General Assembly, and attested by the Clerk of the General Assembly, shall be forwarded to the President of the United States, the United States Secretary of Health and Human Services, the Director of the National Cancer Institute, and each member of the United States Congress elected from the State of New Jersey.
STATEMENT
This Assembly Resolution memorializes the President and the Congress of the United States to endorse and seek to implement changes in current federal government policy, as well as the National Cancer Institute to revise its position, regarding the need for women ages 40 to 49 to receive an annual mammography screening in accordance with the guidelines of the American Cancer Society, and to ensure that the Medicare program covers annual mammograms for its women beneficiaries.
Memorializes President and Congress to support recommendations for annual mammograms for women ages 40 to 49 and Medicare coverage of annual mammograms.