Big Fat Story
Some women will suffer, but far more will benefit.
The anger spurred by the publication of new guidelines for cancer screenings isn’t about health-care rationing or cutting costs, writes The New York Times: It’s about a different way of thinking about risk. When the Preventive Services Task Force recommended that women delay routine mammograms until age 50, they based their findings on a weighing of the risks of the screenings (“over-diagnosis, anxiety, false-positive test results and excess biopsies") against the benefits of the screenings ("one death prevented out of every 1,904 women—a number that drops precipitously as women grow older). Essentially, the task force is saying that, yes, the new guidelines may cause a small handful of additional deaths, but far more women will benefit in other ways. Many Americans, however, find it difficult to consider such a dispassionate cost-benefit analysis in their own health decisions. “People are being asked to think differently about risk,” says Sheila M. Rothman of Columbia University. “They don’t see it in a scientific perspective.”
"Screening has caused me considerable harm."
Though many are up in arms over new recommendations for less-frequent cancer screening in women, some former patients wish they'd skipped the testing they got. One patient in the U.K. was advised to get a double mastectomy after being diagnosed with a mild form of cancer that may never have ended up spreading, and said that “screening has caused me considerable and lasting harm. It has certainly not saved or prolonged my life.” Though screening saves 1,400 lives each year in the U.K., new research shows that if 2,000 women are tested over a decade-long period, 10 women will be given unnecessary treatment for every one woman who is saved. Gratuitous treatment can range from removal or partial removal of breasts, chemotherapy, and radiotherapy, and the U.K. government has had to rewrite its warnings about screening to include these risks. “It is infantilising women,” said the patient of the screening process. “It is patting them on the head and saying ‘There, there, it will be all right.’ It is entirely dishonest.”
Photo: Andreas Rentz / Getty Images
Says it's a sneak peek at government-run health care.
Sensing blood in the water, Republicans leapt on the new mammogram and pap smear recommendations almost immediately, decrying the new guidelines as the first step toward the rationing of health care. “This is how rationing begins,” said Tennessee Senator Marsha Blackburn, while Alaska Senator Lisa Murkowski, hoping to scuttle the new White House-backed health-care legislation, called the report “a peek under the curtain, if you will, of what we can expect with a government-run program.” Berkeley linguistics professor George Lakoff says the GOP’s ability to capitalize on the announcement is partly the Democrats' fault: “They let the moral argument go and had it become an economic argument. As soon as it became a moral argument, they had to bring in cost-benefit analysis. As soon as it goes into cost-benefit analysis, the right wing can attack it as ‘death panels.’”
Photo: AP Photo
Breast Cancer's Death Panels?
New breast-cancer screening guidelines are being called smart science by researchers—and signs of health-care "rationing" by others. The Daily Beast separates fact from fiction.
This debate isn't likely to settle anything.
As the debate rages over the new screening guidelines, The Washington Post points out that it’s not the first time politics and breast health have created controversy: A similar recommendation 12 years ago spurred controversy as well, eventually resulting in congressional hearings and a unanimous Senate rejection of the findings. A National Institutes of Health panel convened in 1997 and advised that routine screenings for women in their 40s may not be advisable given the risks; the Senate, after holding hearings, later voted 98-0 to recommend that the National Cancer Advisory Board endorse the opposite view. And in 2002, the same group that released this week’s recommendations—the Preventive Services Task Force—went the opposite way and advised screenings for the age group in question. The debate over early screenings is “decades-long,” says the Post, and this week’s storm of disagreement isn’t likely to settle anything.
Photo: Michael Dwyer / AP Photo
Some worry that backlash will be a setback to solid research.
As the American Cancer Society and Kathleen Sebelius come out against the new recommendations, some advocates of “comparative effectiveness” research—i.e., studying what treatments are most beneficial (and, incidentally, cost-effective)—worry that the reaction to the Preventive Services Task Force’s announcement will turn some against the movement to include more evidence in medical treatments. Health writer Merrill Goozner points out that stopping routine screenings for women in their 40s could save as much as $2 billion, money that could be used to provide cancer-prevention education and free screenings for women at high risk. Dr. Kevin Pho, a New Hampshire internist, sees the adverse reaction as damning: “If recommendations from an entity like the USPSTF—as nonpartisan and robust as it gets—gets so much resistance from doctors, patients, and even the government itself, findings from a comparative-effectiveness body stand absolutely no chance of changing medical practice.”
This debate isn't likely to settle anything.
As the debate rages over the new screening guidelines, the Washington Post points out that it’s not the first time politics and breast health have created controversy: a similar recommendation twelve years ago spurred controversy as well, eventually resulting in congressional hearings and a unanimous Senate rejection of the findings. A National Institutes of Health panel convened in 1997 and advised that routine screenings for women in their 40s may not be advisable given the risks; the Senate, after holding hearings, later voted 98-0 to recommend that the National Cancer Advisory Board endorse the opposite view. And in 2002, the same group that released this week’s recommendations—the Preventive Services Task Force—went the opposite way and advised screenings for the age group in question. The debate over early screenings is “decades-long,” says the Post, and this week’s storm of disagreement isn’t likely to settle anything.
Photo: Michael Dwyer / AP Photo
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I guess they've decided to throw women under the bus. All of the sudden there are new guidelines. This is rationing. All these years being told start mamograms at 40, now ten years later.
Do you believe this. They have to cut costs to pay for this debacle. First the old folks, now the younger women. Are you going quietly?
Oh please! Stop trying to spread your irrational fears.
Posters such as lachia and diamondgrll-
have no conscience as they go about their way spreading misinformation and fear.
DG implies that the Government is behind these recommendations, when in fact these new recommendations were compiled by teaching hospitals and universities ie. Georgetown University, We all benefit from the best research these institutions of higher learning offer.
There are no federal mandates governing these recommendations, women can and will and should continue to make their own decisions based on reading, thinking and consulting with their doctors.
Since they both post under feminine names, it is sorry that they have the need to be so thoughtless and deceitful in their attempt to turn this into a political issue.
Fortunately they are so deluded they don't take into account that their gender has women, unlike them, who can think for themselves and will push right back against their ilk.
" We all benefit from the best research these institutions of higher learning offer. "
I guess if women in their 20's, 30's, and 40's who found cancer
during those years, took the NEW advice . . . they might be dead.
Nobody " benefits " from lousy NO COMMON SENSE advice.
It is NOT a mandate sophia, so what is you problem? If you are not grown up enough to participate in YOUR OWN DECISIONS, you should not bother advertising it, it is an embarrassing admission. People, all people, make decisions about their health everyday. If it is lousy advice for you, you are free to consider it so.
And further sophia-
If you believe there have been no scientific/and medical advances made over the centuries, you are more to be pitied than scorned.
There is so much misinformation and political grandstanding about this study. It is unfortunate that it came out when it did because it gives the impression that it is directly tied to the current debate about health care reform, (ditto for the PAP test guidelines), however as cbeenthere pointed out, it was not a government study and looks like good science to me. As a 51 year old woman who has no family history and few other risk factors, I am one who probably should have waited until now to start mammography. I have had a mammogram every year since my 40th birthday and when I was in my 30s I got this nifty plastic card to hang up in my shower to do my monthly self-exams. Well, I never put the card up. I have done very few self-exams as prescribed on that card, it seemed too complicated and I always forgot and then felt guilty about it. Having said that, I am and always have been in tune with my body and I am always looking for any changes. My own unique self-exam I guess and I do not think that this study tells women to stop that! I wonder, how much excess radiation have I gotten in the last decade and will that come back to bite me someday?! The study gives new GUIDELINES to be considered based on science, it does not mandate and it does not tell women to stop knowing their own bodies, just that self- exam as prescribed on that card may not be the answer. By the way, the number one killer of women is heart disease. There are guidelines to be followed to prevent heart disease, a healthy diet and exercise but how many of us follow them? Guidelines are just that, if you follow them good for you and if you and your doctor decide to do something else, go for it!
lachica - I honestly wish you would go quietly. Trying to spark up all this hysteria doesn't help. As I remarked to diamondgirl, have you ever considered the facts may be correct. I don't think the government is trying to "throw women under the bus". There are far too many smart women in this country for that to happen. Check out the study and give it a chance. Again, if you have a history of breast cancer or any female cancer in your family, then you should continue your mammos. But, not everyone needs one every year starting at 40.
This task force was appointed by George Bush. Has nothing to do with the current administration. So how does it have a damn thing to do with rationing health care? Is that what Bush was doing? He was the one who chose these doctors on this panel. I'm much more suspicious of the timing of the release. Seems to me it helps the republicans stir up more fears. Just because this panel made the recommendations doesn't mean they adopt the recommendations. Big difference. However, the panel stresses they are made on science and not on cost as they have nothing to do with the cost factors.
This story was yesterday, and it's over.
This story is never going to be over as long as the Government keeps making decisions that the people are unaware of and the death march will begin. Its all over the Sunday morning talk shows, Doctors say that this board will be and has made these types of economic decision, which the insurance co. follow. Why do you think, other services have been denied women in the past and gotten away with it? This is not just an Obama thing its a Bush thing too. This difference is now with all the new technology its become harder to hide, but that wont stop them from trying, when they cant pay for all this new Insurance coverage they are passing as we speak.
I know this will be a radical thought for you; but what if the study is actually correct. What if there's no history of breast cancer in the family, what if self-exam finds nothing over a certain period of time, what if there are too many false positives for those under 50. Then will you think you were mislead in the past or will you actually embrace new science and/or technology. Not every medical decision is intended to put you in the grave sooner; it's an accumulation of medical history and new medical technology. "The death march" is perhaps, just a tad theatrical.
Are you an idiot or are you just playing one? This panel has nothing to do with reform. They were impaneled by Bush. They make recommendations based on science, not cost. They also said very clearly that the decisions on your health care should be made between you and your doctor. If your doctor believes in mammograms for you earlier, than the doctor can order them. Period. The government has not even adopted the recommendations. However, there are far more women out there that do not get any mammograms at any age because they do not have health care coverage. So according to you are your screaming about health care reform, you are perfectly willing to throw all those women under the bus to further your political opinion. You disgust me with your self righteous bull crap that has nothing to do with helping real people but is about furthering your political and religious beliefs. I won't call you what I think of you because it would make this unprintable.
These guidelines are proposed by an independent research group- not the government.Some women get mammograms in their twenties.
On another subject-we are the children and grandchildren,and the debt has been left to us.
daniel76
The doctors own the labs and get a piece of the action
As long as someone else pays the public will demand all the tests they want whether needed or not and doctor will over prescribe
They made similar conclusions about prostate surgery months ago and little hue and cry
If a woman feels compelled to get a mammo or if there's history in her family, then she should/will continue to get one every year. All this panic and carrying on is ridiculous; you are in control of your body. Do what you think is correct. Go to Planned Parenthood; they're still cheap compared to other providers. This sounds like protesting for the sake of protesting.
If the previous standards for breast cancer screenings were based on scientific data, where were all the Republicans screaming about rationing care before? Who's to say that screening shouldn't start at say, age 6? Or 3? Or while the fetus is still in the womb? If we could save even one life, no matter how much money we were wasting on screenings that in no way led to a significant reduction in the number of breast cancer cases, it would totally be worth it. Don't let the government use "science" and "data" as an excuse to ration your care! RABBLE RABBLE RABBLE RABBLE RABBLE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
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