Reps. Wasserman Schultz and Upton Reintroduce Legislation to Protect Women's Access to Mammograms

Today, Congresswoman Debbie Wasserman Schultz (FL-23) and Congressman Fred Upton (MI-06) reintroduced the Protecting Access to Lifesaving Screenings (PALS) Act.

Washington D.C. – Today, Congresswoman Debbie Wasserman Schultz (FL-23) and Congressman Fred Upton (MI-06) reintroduced the Protecting Access to Lifesaving Screenings (PALS) Act. If passed, the PALS Act would protect access to mammograms for women ages 40-49, a routine, lifesaving screening that the U.S. Preventative Services Task Force (USPSTF) currently deems unnecessary for the demographic. Under current law, women age 40-49 would lose access to breast screening coverage with no co-pay when the current extension expires on January 1, 2023. Companion legislation has been introduced in the Senate by Senators Dianne Feinstein (D-CA) and Marsh Blackburn (R-TN).

Since 2009, the USPSTF has given annual mammograms for women ages 40 to 49 a “C” grade, meaning regular screenings are not recommended for that age group. The USPSTF also recommended that women between the ages of 50 and 74 should have mammograms only once every two years, as opposed to annually.

These recommendations remain at odds with clinical experts and leading clinical organizations for women’s health, including the American College of Obstetrics and Gynecology, the National Comprehensive Cancer Network, and the American College of Radiology/Society for Breast Imaging, all whom recommend annual breast screening at age 40. According to American Cancer Society, more than 45,000 women age 40-49 years-old were diagnosed with breast cancer in 2019, and 22 million women between 40 and 49 could be at risk of losing coverage with no co-pay for lifesaving mammograms.

“The notion that breast cancer is a risk only for older people puts young women at risk of not getting a screening that could save their lives. The USPSTF guidelines would exacerbate this problem by discouraging women from getting potentially life­saving mammograms and putting them at risk of losing insurance coverage for screenings,” said Rep. Wasserman Schultz. “As a breast cancer survivor who was diagnosed at 41, I know firsthand the importance of ensuring young women have access to the tools and information they need regarding their breast health. That is why I am proud to reintroduce the PALS Act with Congressman Upton, which extends the moratorium on these ill-advised guidelines and is supported by leading clinical and advocacy organizations.”

“A cancer diagnosis is devastating for patients and their families. Each year, more than 280,000 women tragically get the news that they have breast cancer,” said Rep. Upton. “Fortunately, we know that early detection and regular check-ups can help catch cancer in its earliest stages and truly save lives. The PALS Act will do just that by providing wives, mothers, sisters, daughters, grandmothers, and women nationwide access to lifesaving mammograms and the peace of mind that comes with regular and comprehensive screenings. I am proud to support this important, bipartisan legislation for every woman who has fought and won the battle against breast cancer.”

“On the heels of a pandemic that kept many women from being screened for breast cancer, women now need greater access to screening, not less. Extending the PALS Act protections will avoid a needless decline in screening and thousands of unnecessary deaths each year as a result of implementation of the ill-advised 2016 United States Preventive Services Task Force (USPSTF) recommendations,” said Stamatia Destounis MD, FACR, FSBI, chief of the American College of Radiology Breast Imaging Commission. “Women in underserved areas could be particularly hard hit if the PALS Act protections are not renewed. We urge all members of Congress to support the PALS Act.”

“Black women develop breast cancer on average 5-7 years younger than white women and in fact, 30% of all breast cancers in Black women occur under the age of 50 and 18% occur under the age of 45. The CDC projected last year that roughly 30,000 breast cancers will be diagnosed in women under 45, and 5,000 among Black women under 45,” said Linda Goler Blount, President & CEO of Black Women’s Health Imperative. “USPSTF guidance which does not include this type of data in its development is likely bad policy, but worse, it is bad for the health and wellbeing of the thousands of women ages 40-49 who will be diagnosed with breast cancer. When breast cancer is detected early and quality treatment is received, the 5-year relative survival rate is 100% for all women.”

“Breast cancer has surpassed lung cancer with the highest incidence globally. Protecting access to equitable breast health screening is vital in the fight against breast cancer. Early detection significantly increases a woman's chance of survival, can decrease the amount of treatment necessary and the economic burden to the patient and healthcare entities,” said Holly Rose CEO of Check for a Lump. Check for a Lump wholeheartedly supports Protecting Access to Lifesaving Screenings (PALS) Act and urges all members of Congress to support and extend the PALS act to ensure equitable breast health care.”

 “We screen for breast cancer to find it early, when most treatable and survivable,” said JoAnn Pushkin, Executive Director of “Though breast cancer is more common as women get older, the proposed PALS act protects access to screening beginning at age 40, and that matters because breast cancer is the number one cause of death in women aged 35 to 54 years old and deaths from breast cancer are reduced the most when screening starts at age 40.”

“Cancers will be diagnosed at a later stage and lives will be lost unnecessarily if access to annual screening mammography is delayed for 10 years,” said Lisa Schlager, Vice President of Public Policy at Facing Our Risk of Cancer Empowered (FORCE). “Breast cancer is the most common cancer among American women, with about 20 percent of the diagnoses in those under age 50. FORCE wholeheartedly supports extension of the PALS Act.”

“There is a crucial need for early detection since breast cancer is not only the most common cancer among Hispanic women, it is also more likely to be diagnosed at an advanced stage. Waiting until age 50 to start mammography screening will further disadvantage Hispanic women, jeopardizing their access to preventive care and as a result their health. As a population, Hispanic women tend to seek medical care when they are sick but do not necessarily to seek preventative care like breast cancer screenings,” said Elena Rios, M.D., National Hispanic Medical Association President and CEO. “With better public education and awareness, and the PALS Act, which protects mammography screening coverage with no co-pay for women ages 40-49, we can fight this killer among Hispanic women. Special thanks to Senators Dianne Feinstein and Marsha Blackburn and Representatives Debbie Wasserman Schultz and Fred Upton for their leadership on the PALS Act to protect early breast cancer screening for women ages 40-49.” 

"If diagnosed early, the five-year survival rate for breast cancer is 99%—that's why breast cancer screening is so critical," said Carolyn Aldigé, Founder and CEO of the Prevent Cancer Foundation®. "This reauthorization bill will ensure millions of women have access to this lifesaving screening without having to worry about a financial burden. We commend Senators Feinstein and Blackburn and Representatives Wasserman Shultz and Upton for their dedication to protecting women's health."

"Today, as we emerge from the pandemic, we understand better than ever the devastating effects of delaying screenings and cancer treatment. Continued access to annual screening mammography will save lives,” said Sharsheret CEO Elana Silber. “As an organization dedicated to addressing the needs of young Jewish women at increased hereditary risk for breast cancer, Sharsheret strongly supports the extension of the PALS Act." 

"Breast cancer screening is the most effective way to detect breast cancer early, when more treatment options are available and more lives can be saved," said Susan G. Komen Sr. Director of Public Policy & Advocacy Molly Guthrie. "Thank you to Congresswomen Wasserman Schultz and Upton for reintroducing the Protecting Access to Lifesaving Screenings (PALS) Act so that women everywhere in the U.S. can access needed screening and take control of their health. Without passage of this legislation, women will not be able to get the screening they require, potentially having fatal consequences."

“As a breast cancer survivor who was diagnosed at a young age, I know firsthand how important access to timely screening is, as we know that when diagnosed at later stages results in preventable loss of life.   The PALS legislation is critical to ensuring that all women, particularly younger women and Black women have access, as this demographic tends to have more aggressive breast cancer and higher mortality rates, with Black women dying from breast cancer at 40% higher rate than their White counterparts,” said Maimah Karmo, President and Founder of Tigerlily Foundation. “The Tigerlily Foundation was proud to support the PALS Act in the past and we applaud Senators Feinstein and Blackburn and Representatives Wasserman Schultz and Upton for their leadership on this critical re-introduction.”

The PALS Act is supported by the American College of Obstetrics and Gynecology, American College of Radiology, American Women Unite for Breast Cancer Screening, Black Women’s Health Imperative, Breast Care of Washington, Check for a Lump, DenseBreast Info. Inc, FORCE: Facing Our Risk of Cancer Empowered, Living Beyond Breast Cancer, Men Supporting Women With Cancer, National Association of Nurse Practitioners in Women’s Health, National Black Nurse Association, National Consortium of Breast Centers, National Hispanic Medical Association,  National Medical Association, Prevent Cancer Foundation, Servicewomen’s Action Network, Sharsheret, Society of Breast Imaging, Susan G. Komen, Brem Foundation to Defeat Breast Cancer, and Tigerlily Foundation, and more.