Posted on 11/17/2009 6:29:38 AM PST by chessplayer
Women in their 40s should stop routinely having annual mammograms and older women should cut back to one scheduled exam every other year, an influential federal task force has concluded, challenging the use of one of the most common medical tests.
(Excerpt) Read more at washingtonpost.com ...
I read the article, and it’s not about saving lives (through reducing the effect of excessive radiation) but it’s about saving MONEY. That’s the bottom line.
The previous recommendation of yearly mammogram was not based on evidence of effectiveness, it was a guess made under conditions of ignorance about the actual effectiveness of mammograms.
When evaluating the sort of recommendation you have to keep in mind that "more" or "more frequently" does not necessarily equal better; to give an extreme example if we recommended weekly mammograms cancers would certainly be detected earlier, but only at the cost of radically increased radiation exposures which would likely substantially raise cancer rates.
So the question is, what is the most effective schedule?
As the evidence is studied, we're starting to base such recommendations on actual studies of effectiveness, and it turns out that the benefit of yearly mammograms are outweighed by some of the costs. And there's nothing surprising about this: if you think about it it's highly unlikely that the 12 month guess made under conditions of ignorance would turn out on the basis of pure blind luck to be ideal.
Such decisions really are cost-benefit decisions, and as more (and more accurate) information becomes available we will probably be hearing many more such "unintuitive" recommendations for changes in diagnostic and treatment procedures.him
The previous recommendation of yearly mammogram was not based on evidence of effectiveness, it was a guess made under conditions of ignorance about the actual effectiveness of mammograms.
When evaluating the sort of recommendation you have to keep in mind that "more" or "more frequently" does not necessarily equal better; to give an extreme example if we recommended weekly mammograms cancers would certainly be detected earlier, but only at the cost of radically increased radiation exposures which would likely substantially raise cancer rates.
So the question is, what is the most effective schedule?
As the evidence is studied, we're starting to base such recommendations on actual studies of effectiveness, and it turns out that the benefit of yearly mammograms are outweighed by some of the costs. And there's nothing surprising about this: if you think about it it's highly unlikely that the 12 month guess made under conditions of ignorance would turn out on the basis of pure blind luck to be ideal.
Such decisions really are cost-benefit decisions, and as more (and more accurate) information becomes available we will probably be hearing many more such "unintuitive" recommendations for changes in diagnostic and treatment procedures.him
“Several patient advocacy groups and many breast cancer experts welcomed the new guidelines, saying they represent a growing recognition that more testing, exams and treatment are not always beneficial and, in fact, can harm patients.”
So all of a sudden even treatments are said to be harmful.
And what gives with this?
“The new guidelines also recommend against teaching women to do regular self-exams”
I don’t have a problem with the interval, but the suggestion that the procedure is not needed in those under 50? What about all the women that develop the cancer in their 30s and 40s?
Forget mammogram. Breast MRI is the best thing to do. I had MRI done yesterday to diagnose a lump found on mammogram that needle biopsied “highly suspicious for carcinoma.” It looked like a cyst on ultrasound. I am 39. MRI showed “lesions” on cyst lining impossible to detect on mammogram or ultrasound. Full biopsy later this afternoon and probably start chemo Friday. Prayers appreciated for me, husband, and 10-year-old daughter.
Yep, to provide a medical staff that more closely resembles the ethnic makeup of the the population, the SIEU leaders of enforcement will be conducting ALL future breast exams.
Embrace Diversity!
Thanks for the information. I had a bilateral mastectomy and have implants. My doctors are conflicted on the issue of should I or should I not have mammograms.
I will ask for an MRI.
libby
“What changed in six months to change the USPSTF from a sky-is-falling hysteric on a 1% decline in testing to Emily Litella? If the administration gets its way, the government will be paying for a lot more of these exams when ObamaCare passes. That will put a serious strain on resources, especially since many of the providers will look to avoid dealing with government-managed care and its poor compensation rates.”
“The motivation for HHS will be to cut costs, not to save lives. The sudden reversal in six months of the USPSTF, especially after it made such a stink over a relatively minor decline in screening, certainly makes it appear that they have other priorities than life-saving in mind here.”
“One final thought. Barack Obama predicated his ObamaCare vision on the notion that increased prevention would save costs. Suddenly, his administration is for decreased screening and prevention. Could that have anything to do with the CBO scoring on screening? And what does that say about how government will make decisions once they control the compensation and care in the US?”
“Update: Courtesy of an anonymous reader, here are the members of the US Preventive Services Task Force. See if you can figure out the one thing they all have in common:”
http://hotair.com/archives/2009/11/17/feds-to-women-in-their-40s-skip-the-mammogram/
How many here think MO will be skipping tests?
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