Mammograms: Ideas for Follow-up Stories

The change in U.S. mammogram screening guidelines is certainly big news, and it's not a one-day story. The obvious conflict is the disagreement between some major medical organizations and the United States Preventive Services Task Force, which is now recommending that women get their first mammogram at age 50, rather than 40 as previously recommended.

You can go beyond that conflict (and the related "OMG rationing!" debate) to look at how women will make sense of the conflicting advice they're now getting, examine access to mammograms in your community, and explore the business of mammography. The idea, as always, is to shed light, not generate heat, in your reporting.

First, here's some context for your reporting. The Knight Science Journalism Tracker, which watchdogs science and health reporting, today critiques the most recent coverage. It's also worth reading the Tracker's earlier dissection of some previous reporting on the long-running controversy over cancer screening. This key article in the Journal of the American Medical Association reviews the costs and benefits of breast and prostate cancer screening.

The American Cancer Society, which opposes the new USPSTF guidelines, in 2008 published a review of its cancer screening guidelines and issues which provides some helpful background.This Los Angeles Times story, published in August, reviews the evidence for and against routine mammograms. This Institute of Medicine report, issued in 2004, reviews ways to improve breast cancer screening and expresses concern about the lack of breast imaging specialists (a shortage that might "disappear" if the pool of women who need mammograms at any given time shrinks by millions).

With all that in mind, here are some ideas for follow-up stories.

1. Who gets mammograms in your community, and who doesn't? Check in with your local community clinic or county health department for the anecdotes, then contact your state health agency for the statistics. Many states offer free mammograms to poor or uninsured women and maintain data on the patients they serve. Rohan Mascarenhas of the Newark Star-Ledger recently examined access to mammograms in New Jersey in a story published before the current screening guidelines were released. The U.S. Centers for Disease Control offers a searchable database of state and tribal breast cancer screening programs here.

2. What happens to poor or uninsured women once they are diagnosed with breast cancer? Some state breast cancer screening programs, such as Illinois', subsidize treatment after a breast cancer diagnosis. Others do not. What does your state provide, and are those benefits threatened in the current recession or by state budget cuts? (Here's a grim thought: ask these programs how much money they might save under the new guidelines.)

3. How will large health providers in your area change their policies in the wake of the new guidelines? California reporters, one of your first calls should be to your local Kaiser Permanente spokesperson.

4. How might the new guidelines affect the livelihoods of doctors and the income of hospitals in your area? Mammography is a big business for both.

I welcome your thoughts and story ideas in the comments below. You need to be a registered member of Center for Health Journalism Digital to leave a comment, so if you haven't joined yet, click here.It's easy, quick and free. You can follow us on Twitter, too, @ReportingHealth.