Why did WomensHealth.gov delete its breast cancer web pages?

This question is now being asked because breast cancer content has been greatly reduced on the site, which belongs to the Office on Women's Health (OWH) of the US Department of Health and Human Services (HHS).

While there is still a single page with rudimentary information on mammograms and breast cancer, most of the seven-page content was taken down.

The WomensHealth.gov site is well-trafficked, being visited approximately 700,000 times a month, according to a report.

Critics of the action emphasize that information for low-income women and other vulnerable populations was among the removed content and that its removal appears to reflect a broader agenda from the current administration.

For example, under the auspices of the Affordable Care Act, breast cancer screening is offered free of charge for women meeting certain financial criteria, but that information has been deleted from WomensHealth.gov. Now, the information must be accessed on the site via a link to the Centers for Disease Control and Prevention website, which, in turn, requires a click through to yet another link.

Also, the "Government in Action" section of WomensHealth.gov previously contained information on federal programs that provide free or low-cost cancer screening, including clinical breast exams and mammograms. Known as the National Breast and Cervical Cancer Early Detection Program, the entity offers screening to all "low-income, uninsured, and underinsured women." That entire section of the site is now removed.​

This information cannot be found elsewhere on the OWH website, or anywhere on the HHS site, despite the agency's contention that it has been integrated into other parts of the HHS website.

The deletion of most of the breast cancer content on WomensHealth.gov is startling, said an expert.

"Because breast cancer is the most common cancer for women in the US, affecting 250,000 annually resulting in 40,000 deaths a year, it is astonishing that important information about risks, prevention and treatment of breast cancer has been eliminated from the Office on Women's Health site," Joyce Bichler, deputy director of Breast Cancer Action in San Francisco, California, told Medscape Medical News.

Government Answer: It's Audit Related

According to a report from the Sunlight Foundation, a national, nonpartisan, nonprofit government watchdog, the bulk of the breast cancer–related pages were removed in the second half of 2017 from within the OWH's WomensHealth.gov site.

The government contends that the pages were removed for lack of use and the content is being reviewed. An HHS spokesperson told the news site ThinkProgress that the "pages were removed on December 6, 2017, because content was not mobile-friendly and very rarely used. Before we update any of the information...we engage in a comprehensive audit and use analysis process that includes reviewing other federal consumer health websites to ensure we are not duplicating efforts or presenting redundant information."

The spokesperson also explained that users should go to WomensHealth.gov/cancer. This page does not have a dedicated section for breast cancer, but the spokesperson said "sister HHS agencies…have the same information in a much more user-friendly format on their websites."

Unexplained Censorship

However, the Sunlight Foundation disputes the HHS explanation. They point out that this isn't the first time that important health information has vanished without notice or explanation. The removal of breast cancer information is part of "wider changes to the OWH website that include the removal of resources related to lesbian and bisexual health, minority women's health, and other topics."

In a tweet, Sunlight's Web Integrity Project policy director Andrew Bergman noted that "Our new Sun Web Integrity reports document the removal of breast cancer and LGBT health info from HHSGov's @womenshealth website. This censorship sows real doubt about health considerations for populations of vulnerable women throughout the country."

On their website, the Sunlight Foundation similarly noted that the "unexplained censorship" raises questions about the current administration's commitment to public health. They note that other media outlets have been documenting the broad overhaul of the OWH website since the release of their report and are "delving" into the removal of web pages relating to lesbian and bisexual women's health. WomensHealth.gov was visited nearly three quarters of a million times in a recent month's time, said Sunlight.

"The specificity of these removals adds more evidence to a growing concern: that public information for vulnerable populations is being targeted for removal or simply hidden," says Sunlight. "As we have highlighted before, the absence of transparent process around removing this information, which was done without notice, has sown further confusion."

Breast Cancer Is Political

Breast Cancer Action's Bichler placed the events in a larger context.

"Breast cancer is a public health crisis and social justice issue, and we know that communities of color have higher rates of uninsured people and that access to healthcare is incredibly important for managing illness and obtaining preventative health services," she said.

Bichler emphasized that it is very concerning that important information intended to assist low-income individuals and people of color access healthcare has been removed from the website. "And although mammography information is left on the site, when women don't know how to access affordable healthcare, including medical treatment, we're talking about life and death."

Bichler also pointed out that in the current climate, breast cancer has become "political because women's bodies are political."

This is a step back from addressing and ending the breast cancer epidemic, not a step forward. Joyce Bichler

She concluded that "this is a step back from addressing and ending the breast cancer epidemic, not a step forward."

The oncology community and the public at large should also not be standing by and allowing vital information to be removed and hidden away, Bichler said. "Since this is the government site for the Office on Women's Health, all women, as well as the oncology community, should be demanding an explanation and a return to comprehensive information," she emphasized. "Again — the most common cancer in women is breast cancer and this is all the OWH has to say about it?"

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