20150424 - Apr 24, 2015
ISSUE 16 – APRIL 24, 2015PDF

Foes Immediately Vow to Nullify Task Force Guideline on Mammography for Women 40-49

The breast cancer screening recommendations proposed by the U.S. Preventive Services Task Force earlier this week are basically unchanged from the 2009 version.

WARNING: a reader’s yawn at this juncture would be misplaced.

The recommendations proposed and put in place five years ago were so politically radioactive that they could have jeopardized the passage of the Affordable Care Act.

Indeed, the ACA specifically excluded the task force’s 2009 recommendation on mammography.

Immediately after the 2009 draft recommendation was published, then HHS Secretary Kathleen Sebelius in effect urged women between 40 and 49 to disregard the panel’s evidence-based guideline. An amendment to the ACA, called the “Women’s Preventive Health Amendment,” finished the job of invalidating the guideline. (This made the ACA politically viable.)


Mammography: When, Really, is the Right Time? And at What Cost? 

As a firestorm ignites around the U.S. Preventive Service Task Force draft recommendation on mammography, researchers and advocates are grappling with the questions at the heart of the controversy:

• Should women start screening for breast cancer at age 40 or 50?
• What is the prevalence of false-positives and overdiagnosis in these age groups?
• What are the costs of harm?

The USPSTF draft recommendation, published April 20, comes on the heels of a controversial study which estimates that the

U.S. spends $4 billion a year on unnecessary mammograms for women between the ages of 40 to 59.

Mandl: Costs of Harm from Mammography Must Be Balanced Against Benefits

The U.S. spends $4 billion on unnecessary mammograms each year, according to a study published in the April issue of Health Affairs.

Titled “National Expenditure for False-Positive Mammograms and Breast Cancer Overdiagnoses Estimated at $4 Billion a Year,” the study, by Kenneth Mandl and Mei-Sing Ong, uses expenditure data from a major U.S. health care insurer for 702,154 women in 2011 to 2013.

Of the $4 billion, $2.8 billion is attributed to false-positive mammograms, and $1.2 billion to breast cancer overdiagnosis. The study measures the rate of false positives at 11 percent and overdiagnosis at 22 percent.

Wender: Mammography Guidelines Should Balance Benefits and Risks, Not Costs

“Let me be really clear: I don’t think that article should have or will have any impact on the [US Preventive Services Task Force], and it will not have any impact on [the American Cancer Society] guidelines, either,” Wender said.

 

Four Decades of Mammography Wars

The latest draft guideline by the U.S. Preventive Services Task Force is part of nearly a four-decade war over the appropriateness of screening women between the ages of 40 and 49.

In this war, Congress usually intervened, claiming that “common sense” dictates that mammography is efficacious in younger women. This war has often engulfed NCI.

This timeline appeared in part in the Nov. 20, 2009, issue of The Cancer Letter.

AACR Annual Meeting 2015

  • Jose Baselga becomes president of AACR

  • Two Stand Up To Cancer Dream Teams launched in ovarian and lung cancer

  • Multiple award winners named

The Cancer Letter Receives Sigma Delta Chi Award

The Cancer Letter won a 2014 Sigma Delta Chi Award for Public Service in Journalism from the Society of Professional Journalists on April 23.

The Sigma Delta Chi Awards is a national competition dating back to 1932. The award recognizes Matthew Ong’s series “Power Morcellation: A Hazardous Practice” as the winner in the Newsletter category.

“This award recognizes a newsletter that renders outstanding public services through extensive coverage of an issue facing the community it serves,” the description reads.

Ong’s series, which includes an interview documentary, can be found here.

20150417 - Apr 17, 2015
ISSUE 15 – APRIL 17, 2015PDF

Lowy: “We Need to Continually Look at the Distribution of Funds That We Allocate to the Areas of Investment”

Douglas Lowy became the NCI acting director April 1. On April 16, Lowy spoke with Paul Goldberg, editor and publisher of The Cancer Letter.

Paul Goldberg: Congratulations, first of all. How is the job treating you?

Douglas Lowy: Well, it is certainly a lot of work, but it’s an incredible opportunity—I have the opportunity of working with terrific people every day. I love it.

PG: Did you want this job?

DL: I never thought of myself as either becoming acting NCI director or the permanent NCI director, and it was not something I lobbied for.


MD Anderson Execs Get Big Raises In the Midst of Faculty Morale Woes

  

 

Two top administrators at MD Anderson Cancer Center, whose job responsibilities include maintaining harmony with the faculty, received substantial pay increases for having “excelled beyond expectation” and “effectively” directing the center’s clinical activities.

According to documents obtained by The Cancer Letter under the Texas Public Information Act, MD Anderson Provost Ethan Dmitrovsky and Physician-in-Chief Thomas Buchholz received $200,000 each in deferred compensation in 2015.

With incentive pay, supplemental annuity and deferred compensation included, the 2015 raise could boost Dmitrovsky’s total paycheck by as much as 22.9 percent compared to fiscal 2014. Buchholz’s compensation could increase by 31.4 percent.

Lawmakers Repeal Medicare SGR in Bipartisan Vote

President Barack Obama signed the Medicare Access and Children’s Health Insurance Program Reauthorization Act on April 14, permanently repealing the Medicare sustainable growth rate formula.

The bill received overwhelming bipartisan support: The House of Representatives voted 392 to 37 on April 2, and the Senate approved it with a 92 to 8 vote April 14.

In Brief

  • NCI renews Purdue’s designation as an NCI Basic Science Cancer Center

  • Joseph Gulfo named executive director of the Rothman Institute at Fairleigh Dickinson University

  • Don Gabriel joins United BioSource Corp.

  • Children’s Hospital of Wisconsin opened its MACC Fund Center clinical and Northwestern Mutual Day Hospital

  • Roche acquires CAPP Medical

Drugs and Targets

  • Health Canada approves new indication for Xtandi

  • Bayer HealthCare expands global clinical development of copanlisib

  • Immunocore and MedImmune enter into second collaboration

20150410 - Apr 10, 2015
ISSUE 14 – APRIL 10, 2015PDF

MD Anderson Violated Academic Freedom, Governance, Tenure Standards, AAUP Says

MD Anderson Cancer Center President Ronald DePinho’s administration acted in disregard of academic standards and the institution’s internal faculty appointment policy, according to a 23-page final report published April 8 by the American Association of University Professors. 

 The report is the outcome of a yearlong feud between the cancer center and AAUP, which defends academic freedom and shared governance.


  

Congress Steps in to Examine FDA Device Regs As Insurers Restrict Coverage of Morcellation

Nearly a year and a half after a surgical tool routinely used by gynecologists disseminated her undiagnosed sarcoma, Amy Reed found herself back in the operating room—this time for removal of a second metastasis.

Reed’s leiomyosarcoma, which had been in remission after a massive surgery and post-morcellation chemotherapy, has spread to her lumbar vertebrae.

False Positive Mammograms, Overdiagnosis Cost $4 Billion

The costs of false-positive mammograms and breast cancer overdiagnoses add up to $4 billion a year, according to a paper in the April edition of the journal Health Affairs.

The issue contains a cluster of papers focusing on the cost and quality of cancer care.

Draft Guideline on Colorectal Cancer Biomarker Published

The American Society for Clinical Pathology, the College of American Pathologists, the Association for Molecular Pathology, and the American Society of Clinical Oncology released a draft of a clinical practice guideline on the use of molecular marker testing for patients with primary or metastatic colorectal carcinoma.

This evidence-based guideline will help establish standard molecular marker testing, guide targeted therapies, and advance personalized care for these patients.

In Brief

  • Karen Jensen joins Scripps Health as director of the oncology clinical care line

  • Chandini Portteus named president and CEO of LIVESTRONG Foundation 

  • Margaret Hamburg, former FDA commissioner, appointed foreign secretary of IOM

  • The NCCN Foundation awarded fifth series of Young Investigator Awards to six oncology researchers

  • Christina Coughlin named chief medical officer of Immunocore Ltd.

  • Gerrit Los named vice president of pharmacology at AnaptysBio Inc.

Drugs and Targets

  • Vectibix gets European approval for wild-type RAS colon cancer

  • Intrexon Corp. signs cooperative research and development agreement with NCI

  • Rubicon Genomics Inc. extends its clinical supply agreement with Agendia

  • Merck and Pfizer will begin co-promoting Xalkori in eight countries