on our broadcast tonight -- mammograms at 50 and not 40. that recommendation is now causing anger and confusion and fear. tonight, what are women in their 40s supposed to do? down to business. a critical day for president obama in china. high and dry. here in arizona, the all-out effort to preserve something very precious and scarce. attention shoppers, are you being duped? a new warning about deception on the web that can cost you. and tonight's "making a difference" report. a game is teaching young men to tackle tough times on and off the field. "nightly news" begins now. captions paid for by nbc-universal television good evening tonight from phoenix. a generation of american women has grown up believing that turning 40 means getting your first mammogram. suddenly yesterday we all learned that recommendation jumps ahead ten years to the age of 50. and a change that big, that sudden, isn't being taken lightly. women are surprised, they're angry, their skeptical. some are scared they're going to miss something. it's serious business having to do with the number two cancer killer of women in this country. and because no two women are alike, because no two stories are alike, and because so many of us have lost someone in our lives to breast cancer, this has started a huge debate understandably. we'll begin our coverage here tonight with our chief medical editor, dr. nancy snyderman. >> reporter: across the country today, women of all ages were talking about breast cancer. >> i have a mammogram every year, and i don't knowly should now or not. >> reporter: in particular a new set of guidelines issued yesterday by an independent panel of experts, which changes the recommendations regarding who should get mammograms and when. >> turn in a little more. >> reporter: i'm in my 40s and i have had mind and it gives me a peace of mind everything is okay when you get it. >> reporter: new guidelines now recommend women ages 40 to 49 should not be routinely screened unless they're at risk for breast cancer. and women ages 50 to 74 should be screened but only two years. many women are saying it's a mixed message. >> there's a lot of confusion within the medical community as far as i understand, so -- >> reporter: despite the recommendation, some doctors from the u.s. cancer center are saying for now they are sticking with the consistent guidelines, screening their 40-something patients every year as they always have. >> we strongly believe the begins in their 40s and continue throughout the 50s and 0s. >> reporter: cindy pearson is with the national women's health network, who is in favor of the new guidelines. >> because they help us to move forward that help us find something that could possibly save many more lives than mammography has ever been able to do. >> reporter: another concern is that this change of recommendations will be an opportunity for insurance companies to stop paying for some breast cancer screening. so far, the industry is staying the course. >> women who have discussions with their physicians about the potential benefits and harms and want to go ahead at a younger age with a mammogram, that, tha >> reporter: it's important to remember that these new recommendations from that independent task force are just that, there's recommendations. they don't mandate any changes in who should get mammograms and when. and so far, from what we've heard all from women across the country, there is still a lot of confusion. >> and, nancy, let's try to clear some of that up. in our own editorial meeting this afternoon, a woman in our staff said in my 40s, i have an appointment for a mammogram next week. should i keep that appointment? >> brian, she's the ideal person to sort of pause and think, these guidelines are really written to me. no risk factors, no family history. she's one of those people who could really question whether she should wait until 50 and have that conversation with her physician. >> and with people currently so suspicious about insurance companies and for that matter a lot of doctors, how quick do you think the pace of change will be? will this -- will this washington through the medical community slowly or quickly? >> i think this is a seismic shift for the message. i don't, however, think it's going to be a seismic shift in how doctors prescribe. slowly, we'll see the younger doctors take this on. the doctors who are entrenched and believe that they're working on anecdotes and what they see in their offices, how they want to practice medicine. i suspect those doctors will be a little slower to pick up on those recommendations. >> as i mentioned, we all have our own anecdotal personal stories. my e-mail file today -- and i imagine yours as well -- filled up with e-mails from so many women between the age of 40 and 50 saying, i am a survivor. i wouldn't be a survivor today had my tumor not been caught by a mammogram when i was in my 40s. how do you address that? what do you say to all of those women? >> brian, that's where we have to be really careful to remember that anecdotes in this big body of science don't necessarily jive. the anecdotes are important but they're individual studies, and this big piece of new information, in fact, looks at all of the numbers and takes a lot of the emotion out of it. i think that's one of the hardest messages for today. whether or not this was a false safety net for most of us, the experts on this panel are saying that the data speaks for itself, in fact, that it's very strong. brian? >> and, again, bears repeating, this was a recommendation after all. dr. nancy snyderman, our chief medical editor with us from our new york studios tonight. thanks. >> you bet. as we said, we received hundreds of your questions and comments on these guidelines all throughout this day. dr. snyderman has answered more of them on our website and will continue to. that's nightly.msnbc.com. another piece of health news getting a lot of attention tonight involves all kinds of brand names you have heard on commercials. one specifically, a popular type of heartburn drug can interfere with the blood thinner plavix, which millions of americans take to reduce the risk of heart attacks and strokes. because plavix can upset the stomach, it is often prescribed alongside drugs like prilosec and nexium. the problem now, according to the fda, is that pro lie sec and nexium, weaken the evict of plavix. better choices, according to the fda, may lantia and zantac, different classes of stomach medicines. overseas now, president obama has wrapped up another full day in china, including meetings with president hu jintao. there was a lot of pushback between the two of them behind the warm welcome for the visiting president. our white house correspondent savannah guthrie, traveling with president obama in beijing, with apologies for a long satellite delay tonight. savannah, good evening. >> reporter: good evening to you, brian. this was the day of the real business of the trip. and despite a lot of talk about a new era of cooperation, it's clear this will take time and the president will leave china with the same fundamental disagreements intact. in sub freezing temperatures, the temperature toured beijing's forbidden city, once the home of emperors. >> it's beautiful. >> reporter: the president's second day in china was long on ceremony, an official welcome with the formal review of the troomz and tuesday night an elaborate state dinner. it was also the most substantive day of the visit. president obama and chinese president hu jintao holding a series of meetings and appearing later before the press to hail the common ground they share as the world's largest powers. >> the united states welcomes china as a strong, prosperous and successful member of the community of nations. >> reporter: but both leaders raised touchy economic issues. chi china's president urged mr. obama to avoid protectionist measures that could curve china's massive dependence on u.s. experts to power its economy. mr. obama reminding china of its promises to stop manipulating its currency to keep chinese goods artificially cheap. but aides say the chinese never brought up the u.s.' $800 billion debt, money largely used to fund stimulus efforts. though the president later appeared to make a passing reference. >> china's partnership has pulled critical in our effort to pull ourselves out of the worst recession in generations. >> reporter: the chinese took a firm line against iran and north korea, but in a sign of the diplomatic work still to be done, made no commitments to support sanctions against iran, its economic ally. and at a press event so tightly managed, no questions were permitted. mr. obama gently nudged his hosts on human rights. >> we do not believe these principles are unique to america, but rather they are universal rights, and that they should be able to all peoples. >> reporter: the leaders did make some progress on climate change. no major breakthroughs on capping greenhouse gases but they did pledge cooperation on clean energy research. on wednesday, the president will meet with the premier of china, and then its onto korea. but one last sightseeing stop, the great wall of china, brian. >> savannah guthrie, as morning gets under way in beijing. savannah, thanks. in iran, state-run television is reporting five more people have been sentenced to death from the chaos, the massive street protests following the elections back in june. the government said the five democracy protesters were members of the terrorists and armed opposition groups. at least three other protesters have already received death sentences for their role. now to a hoss stot story bae in the desert southwest. we're reminded of a yoet often attributed to mark twain. it goes like this. "whiskey is for drinking. water is for fighting over." it's true, water is a fighting word in arizona. as natural resources go in this part of the country, water is precious and contentious. as part of our week-long series on our planet, our chief environmental correspondent anne thompson has our report tonight from flagstaff. >> reporter: in the high desert of northern arizona, where the drought is in its 15th year, conservation is now a way of life. >> look at the fruit. >> reporter: nothing gets wasted at chuck mcdougal's organic farm in flagstaff. the locals eat barley left over from a brew pub. fruits and vegetables grow in repurpose tubs and bins collected by the water from a greenhouse woof. >> because we only have eight to ten inches, we probably only caught about 3,000 gallons. >> reporter: is that enough to keep it going? >> no. >> reporter: and in a group so bad of 65,000, springer is a local geologist. is flagstaff in danger of running out of water? >> flagstaff has nur water to get it into the near future but there are concerns about the supply out to 2050. >> reporter: those concerns are hard to miss. believe it or not, this is a lake, or it was. lower lake mary, a dire illustration of the problem. but a problem officials think they can manage long into the future. the key is conservation. jim ryun is flagstaff's deputy's city manager. >> believe it or not, that is a dam, and on a good year, the water should be bumping up against the top of that dam. >> reporter: today it is only one-third full, not ideal, but enough. this decade even as flagstaff's population increased 21%, its water consumption fell 37%. that's the formula to make flagstaff viable for the future, because drilling 2,000 feet down into the red rock to get water is very expensive. >> to drill a well and equip it, it averages at about $2.5 million. >> reporter: julie and mark lancaster say conservation has cut their family's water bill in half. there's a button to pause the shower. water used to washed clothes can be directed to apple trees or the sewer and the landscape is all native plants. >> because those things are in place, i don't have to think about it anymore. >> reporter: making conservation second nature in an area where nature's water is scarce. anne thompson, nbc news, flagstaff. and from flagstaff back here in phoenix, when our broadcast continues on a beautiful tuesday evening, it might look like a tempting offer but one click could cost you big time. we'll have the story. and later, it's more than just a game. for some kids, this team is making a real difference. er-gen, ecoboost™ engine in the all-new taurus sho from ford. that has the thirst of a v6 with the thrust of a v8. we speak car. we speak innovation. introducing the all-new taurus sho from ford. drive one. some people will stick with their old way of getting vitamins and minerals. others will try total raisin bran. with 100% of the daily value of 11 essential vitamins and minerals and the luscious taste of plump, juicy raisins and crunchy whole grain flakes. ... ... guess it's all about what kind of crunch you like. how are you getting 100%? visit totalcereal.com and get a coupon. how are you getting 100%? this holiday, do you really want to cut corners by using a broth with msg? only one canned chicken broth has no msg. so for a perfect holiday meal, the secret is swanson, 100% natural chicken broth. and to keep beef juicy and bring out its natural flavors, use swanson stock. headaches know when you're stressed. tired. running on empty. to relieve headaches doctors recommend tylenol... more than any other brand of pain reliever. tylenol rapid release gels... release medicine fast... to silence headache pain fast, so you can feel better... knowing you can stop a headache... as quickly as it starts. we're back here in phoenix tonight. at this time when so many americans are being so careful about what they spend, there is a new warning about how online shoppers are being tricked into paying for something they don't even what, imagine that, because of deceptive offers on popular websites. our report on this tonight from our senior investigative correspondent lisa myers. >> reporter: ann mckie had been on shutterfly buying photos and later found some unwanted charges on her credit card, monthly fees for a membership club called reservation rewards. >> this was going for a service which i did not want, did not need, and had no knowledge of getting. >> reporter: today a senate committee said millions of consumers have unwittingly signed up for these clubs. and investigators accuse the companies involved of aggressive sales tactics intentionally designed to mislead online shoppers. >> tricking customers into buying goods and services that they do not want is not okay. >> reporter: an expert shows us how it works. after you buy something on popular websites, another offer pops up. it looks like a coupon from the retailer, but it's actually from a third party company. click on, and you will be billed every month for a discount membership club, a fact often disclosed only in the small print. >> what's most deceptive is that your credit card is charged without you ever typing in your credit card number. >> reporter: that's right. when you click, the retailer simply gives your credit card number to the membership club, in return for a fee. investigators say hundreds of retailers, sites for travel and hotels, movie tickets and flowers, have collectively earned almost $800 million by participating in these deals. >> reputable sites are actually being reimbursed by the companies that are scamming you. >> reporter: the ceo of one membership company, web loyalty, insists there is no trickery, and in august started requiring customers to submit the last four digits of their credit card number. >> the investigators claim that your ads are deliberately deceptive. >> that's not true. we worked hard over time to try to make our sign-up process clear to make sure that people understand what they're signing up for. >> reporter: the membership club companies insist their offers are clear and unambiguous and acquire affirmative steps. the retailers who allow their sites to be used also say the offers are completely clear and claim that they get very few complaints. lisa myers, nbc news, new york. >> speaking of money, on wall street today back home in new york, another upday with the dow gaying more than 30 points. blue chips are now up for nine of the past ten trading days. when our broadcast continues in just a moment, more about money. what you should know about some new airline surcharges. is that a fancy word for fare hikes? i had chronic muscle pain all over. and i was so tender to the touch-- but i didn't know why. my doctor diagnosed it as fibromyalgia. and then he recommended lyrica... fibromyalgia is thought to be the result of over-active nerves that cause chronic, widespread pain. lyrica is fda-approved to help relieve the unique pain of fibromyalgia. so now, i'm learning what a day is like with less pain. lyrica is not for everyone. tell your doctor about any serious allergic reaction that causes swelling or affects breathing or skin, or changes in eyesight including blurry vision or muscle pain with fever or tired feeling. lyrica may cause suicidal thoughts or actions in a very small number of people. some of the most common side effects of lyrica are dizziness, sleepiness, weight gain and swelling of hands, legs, and feet. do not drink alcohol while taking lyrica. you should not drive or operate machinery until you know how lyrica affects you. could your pain be caused by fibromyalgia? ask your doctor about lyrica today. by changing her medicare prescription plan. all we had to do was go to cvs.com and use the free savings calculator. we learned that changing your medicare part d plan could save an average of $612. woman: we just entered my prescriptions, and it compared plans for us. it was easy to find the right plan for the prescriptions i need. your cvs pharmacist can help, too. come in today, or go to cvs.com before december 31st to find the best plan for you -- at cvs/pharmacy. general motors said today it's staying in detroit. gm, which is restructuring in bankruptcy, had considered moving out of renzen, as it's called, downtown high-rise renaissance center when the city of michigan made a sweeter offer of tax credits to get the company to stay. and ford got another shot today. the ford fusion has been named the annual trend car of the week. the annual award is considered a huge marketing boost in the car business. fusion is already the tenth best-selling car in the country, and it is the best-selling car built by a u.s. automaker. they have added fees in the past for baggage and food and pillows and blankets, and now major u.s. airlines, including delta, united, northwest, us airways, are either adding or increasing another surcharge, as they call it. in effect it's a surcharge for flying when a lot of people want to fly. for flying during the busiest times of the year like spring and summer. the amount of this surcharge, perhaps we should go ahead and call it a fare increase, it all over the map. it seems to begin at around $30. how about you want to fly the day after the super bowl? that surcharge will cost you $50 extra days on top of your ticket price. that mountain over our shoulder here is camelback mountain here in phoenix. and a package recently arrived not at all far from here at cam camelback high school. it contained two library books and a money order from $1,000. the books are from a series called "the xmunty of living things." one is about forest and woodland. the other is about field and meadow. both were checked out of the library in 1958, right before the student moved, along with the books, to a new home in colorado. the package contained a note saying the sender hoped that at a rate of two cents a day for 51 years, they hoped $1,000 who cover all fines and fees. when our broadcast continues from phoenix in just a moment, undefeated on the field, but for this team, there's an even bigger victory to tell you about. only one canned chicken broth has no msg. so for a perfect holiday meal, the secret is swanson, 100% natural chicken broth. and to keep beef juicy and bring out its natural flavors, use swanson stock. 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(sssssssss!!!) zantac. because we believe that ideas are limitless. that's why, everyday at ge, thousands of scientists and researchers at our global research centers and throughout the company are redefining what's possible by creating the advanced technologies that create jobs. the american renewal is happening right now. for high school football players all across this country, this is end-of-season crunch time. a lot of hopes and dreams are on the line, including at the famous nebraska school for troubled kids noeknown as boys town. but no matter what happens for this so far undefeated team, the lessons of success are already there because of a program that's "making a difference." we get the story tonight from nbc's kevin tibbles. >> reporter: imposing on the field, formidable offense. they call it boys town mrid. >> touchdown! >> reporter: my philosophy is pretty simple. it is to use the game of football to build a better young man. >> reporter: the boys town cowboys, undefeated this season in boys town football, hailed from boys town, africa, which cares for at-risk boys and girls. founded years ago by father flanag flanagan, who was portrayed by spencer tracy in the movie "boys town." >> if there's one thing in the world i really know it is that there's no such thing as a bad boy in the world. i'm sure of that. >> all of them had dropouts, school truancies, school kickouts. >> reporter: now he has found a true sense of belonging. >> it makes me feel like i'm important. it makes me feel that i'm wanted and needed and cared about. >> reporter: football's been around a part of boys town since t the dirty '30s. the team has fans pack the stands. and just in case you're wondering, they were the cowboys long before their dallas namesakes. a group of very troubled men. but winning this time off the field is even more important. fair play and responsibility. hall marks of a team that lives by the boys town credo, "oo"he ain't heavy. he's my brother." >> they bought into something bigger than themselves. that makes us extremely proud. >> and it really shows what an underdog can do. >> reporter: senior chris thompson has a new goal -- college. >> you can make it. i made it. i'm not done yet. i still have a lot of work to do. i'm a better person because of this. >> reporter: come at game time, the stands are filled with i rest of boys town kids. this is family and for many, this is the first family they've ever really known. kevin tibbles, nbc news, boys town, nebraska. and that's our broadcast for this tuesday night. thank you for being with us. i'm brian williams reporting tonight from phoenix. we hope you will be with us again tomorrow evening. good night.

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