Recommendations, apparently, have consequences.

Last November, in a hotly debated move, a federal panel suggested that routine mammograms begin for women at age 50 rather than the more usual age of 40. Now a survey by the Avon Foundation for Women of breast cancer educators and providers says that some women aged 40 to 49 are experiencing less access to these screening tests.

“We found that 12 states are shifting from starting mammograms at age 40 to age 50,” reports Marc Hurlbert, PhD, scientific director of the Avon Foundation Breast Cancer Crusade. “It’s concerning that state or local agencies are starting to use the guidelines arbitrarily in the face of a financial crisis.”  Hurlbert admits to being “a little surprised” by the survey findings. “If you hear the government experts, they say they aren’t making changes. But we’re hearing something different from people on the ground,” he says.

Women may also be backing off from mammograms of their own accord. Some survey respondents felt that women under 50 who were already reluctant to undergo the screenings may be using the non-binding guidelines, proposed by the U.S. Preventative Services Task Force, to rationalize opting out.

The government changes primarily affect lower income and uninsured women, says Hurlbert; the survey spotted no definitive shifts in the reimbursement policies of insurance companies. Nor is there any evidence that high-risk women under 50 are getting turned away from having mammograms.

Hurlbert says that the Avon Foundation will continue to monitor the situation and will conduct another survey in a few months.