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Tuesday, November 17, 2009

Or is it just about saving money?
Posted by Jill | 6:37 AM
When you have a health care "reform" bill in the Senate that not only may effectively make abortion a non-reimbursable procedure, but also does not explicitly cover procedures that are unique to women, you have to wonder if women's health care is going to be sacrificed on the altar of cost containment. That's why I'm skeptical about the mammography guidelines put forth yesterday by the United States Preventive Services Task Force:
The new recommendations, which do not apply to a small group of women with unusual risk factors for breast cancer, reverse longstanding guidelines and are aimed at reducing harm from overtreatment, the group says. It also says women age 50 to 74 should have mammograms less frequently — every two years, rather than every year. And it said doctors should stop teaching women to examine their breasts on a regular basis.

Just seven years ago, the same group, the United States Preventive Services Task Force, with different members, recommended that women have mammograms every one to two years starting at age 40. It found too little evidence to take a stand on breast self-examinations.

The task force is an independent panel of experts in prevention and primary care appointed by the federal Department of Health and Human Services.

Its new guidelines, which are different from those of some professional and advocacy organizations, are published online in The Annals of Internal Medicine They are likely to touch off yet another round of controversy over the benefits of screening for breast cancer.

Dr. Diana Petitti, vice chairwoman of the task force and a professor of biomedical informatics at Arizona State University, said the guidelines were based on new data and analyses and were aimed at reducing the potential harm from overscreening.

While many women do not think a screening test can be harmful, medical experts say the risks are real. A test can trigger unnecessary further tests, like biopsies, that can create extreme anxiety. And mammograms can find cancers that grow so slowly that they never would be noticed in a woman’s lifetime, resulting in unnecessary treatment.

Now that said, I have a certain amount of skepticism about mammograms, for all that I have one every year. I'm not sure I believe that they CAUSE breast cancer, as some believe (though I wouldn't rule it out, this IS women's health care that is aimed at women who are no longer "fuckable" and are therefore expendable in our society), but whether they prevent deaths remains to be seen. And then when I start thinking that way I think of the family friend who never had a mammogram and by the time her cancer was discovered, she had significant lymph node spread.

The timing of this report has my spidey-sense a-tingle, coming as it does from a group that advises doctors and insurance companies. If you think this report isn't going to affect coverage for mammograms, you're deluding yourself. And it just seems peculiar that it's WOMEN'S health care that is getting this kind of scrutiny.

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8 Comments:
Anonymous Skepticat said...
And precisely how does it benefit anyone to have women not do self-exams? Cost containment? Have I been neglecting to bill someone? I know several women who found their own cancers this way. And I have at least five friends alive today only because a routine mammogram found problems early. Arrrggghhh.
11/17/09, 9:02 AM  
Blogger Cirze said...
Thank you, Jill!

I was just reading those "new and improved" guidelines in this morning's paper in dismay.

Not do breast self-exams? How possibly could that be better than doing them?

Oh, right. Less cancers will be found and therefore less procedures will be needed.

Cagey, ne c'est-pas?

The "thinking" representatives?

Jamais!

Thanks, again!

S

That's why I'm skeptical about the mammography guidelines put forth yesterday by the United States Preventive Services Task Force
11/17/09, 9:19 AM  
Anonymous mandt said...
The new Republican Health Reform Bill says it all: http://adgitadiaries.blog-city.com
11/17/09, 3:13 PM  
Blogger Nan said...
I can understand the cutting the frequency of mammograms to 2 years, but the not teaching women to do self-exams seemed odd until I took a look at the actual recommendations, not just MSM summaries. Apparently women who do BSE have a higher rate for false alarms and unnecessary biopsies than women who don't.
11/17/09, 3:45 PM  
Blogger Nan said...
BTW, cancer specialists have been talking about cutting back on over-zealous screening for a number of cancers, not just breast cancer. There's a fear in the medical community that too many patients are being subjected to unnecessary pain and suffering by being treated for cancers that grow so slowly that in the normal course of events (i.e., no intervention) the patients would die of other causes (like old age) before the cancers affected them.
11/17/09, 3:57 PM  
Anonymous tsisageya said...
America has become the land where we do what we want and torpedos full speed ahead!
11/17/09, 8:34 PM  
Anonymous Orin T said...
Substitute breedable for for fuckable and you have a point.
11/17/09, 9:50 PM  
Blogger Rhode Island Rules said...
Let's face it ladies, men in this country hate us as much as men in the women as forced subservient and honor killing countries. They want sex and they want to create children (help raise them, not so much) but respect us, take us seriously, work with us as equals? Yeah, not so much. Blame their own problems on us - yup, always.

Yes, it is a generalization but then again...?
11/17/09, 9:51 PM  
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