Patients, doctors, journalists criticize “Free Preventive Mammograms” campaign

Gary Schwitzer is the founder and publisher of HealthNewsReview.org.  He tweets as @garyschwitzer, or uses our project handle, @HealthNewsRevu.

Journalist Cathy Shufro was riding a New York City subway train when she looked up at that rail of ads that we’ve all seen on mass transit vehicles. What she saw bothered her. She pulled out her phone, took a picture, and sent it to me with a subject line – “mammograms prevent (something).”

Oscar is an insurance company. We are all accustomed to insurance companies telling us what they will do for us. But their campaign touting mammograms as preventive doesn’t help anyone. And mammograms, as members of our editorial team were quick to emphasize, don’t prevent cancer. The following are all email comments sent to me in response to my request for a reaction to the ad campaign.

Breast surgeon Deanna Attai, MD, a past president of the American Society of Breast Surgeons, wrote, “Mammography is a diagnostic tool – it is meant to diagnose cancer. No imaging test can prevent cancer.”

She wrote that she has occasionally met with women who are surprised they got breast cancer after getting annual mammograms.  “I think after many years of hearing ‘early detection saves lives,’ on some level, even if only wishful thinking, some patients do feel a sense of security in that annual mammogram – as if it could prevent cancer.”

‘We have to stop giving people inaccurate information’

Mandy Stahre, PhD, is an epidemiologist. She was diagnosed with breast cancer at age 31. She wrote, “There’s nothing preventive about having a mammogram. Getting a mammogram doesn’t decrease your risk of disease. It’s not like eating healthy, getting physical activity, or quitting smoking. We have to stop giving people inaccurate information on what a mammogram can and cannot do for women.”

Suzanne Hicks is another member of our editorial team who was diagnosed with breast cancer – in 2003. She wrote, “Free. Preventive. Mammograms. Putting these three words together is a cheap way to catch the attention of fatigued subway riders in NYC. Mammograms are never free emotionally. Nor do they prevent breast cancer, as implied by the picture of the perfectly rounded breast. This insurance company needs either further education or a lesson in ethics.”

Sue Rochman is an independent health care writer/editor who has specialized in cancer issues for more than two decades. She wrote, “The ad infers that Oscar is doing something above and beyond other insurers by offering ‘free’ mammograms. But Oscar is only doing what it is required to do. By law, under the Affordable Care Act, all marketplace plans and many other plans are required to provide mammography screening–at no charge. (See https://www.healthcare.gov/preventive-care-women/). To be sure, HealthCare.gov perpetuates the idea that mammography is prevention by including it under women’s preventive services.”

‘This confusing language is everywhere’

Finally, Virginia Moyer, MD, who once chaired the US Preventive Services Task Force (USPSTF), wrote, “I think this confusing language is everywhere since most so-called preventive services don’t actually prevent what they reference. More often they are intended to result in early diagnosis and potentially better outcomes – but we still call them preventive services.”

Moyer experienced a great deal of controversy over issues surrounding screening tests during her time on USPSTF, so she’s probably more laid back (her term) about this particular ad campaign than other experts we turned to for comment.

But the words do matter. From our limited sample of reactions from smart women on our editorial team, the Oscar campaign will win no awards. Misleading, inaccurate, confusing, unethical would be the words that fit better than “free…preventive…(or) I’m covered.”

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Charles Carter

January 25, 2018 at 6:52 pm

I would have had a reaction similar to most of those here about the description of mammography as preventive. Yet very few lay persons understand the difference between diagnostic and screening exams, and probably care little about screening vs prevention. So I’d say Ms Rochman‘s comments about advertising that the company abides by the law is the most salient.