While the outcry rages over the U.S. Preventive Task Force’s recommendation that women under 50 should get a mammography every other year, the damage may have already been done. Women who were predisposed, for whatever reason, to skip annual breast examinations may become even more so.
The outcry among doctors and health administrators, and the back-pedaling done by the Task Force is significant, but women looking for an excuse or justification for procrastination on clinical breast exams may have found it. Hopefully, they’re still listening to the debate as it rages.
The sad truth is, not enough women have breast examinations – period – regardless of recommendations. According to the American Cancer Society*, only 51.2 percent of women over the age of 40 had a mammogram last year. For exams in the past two years, the number is better – 66.5% – but still unacceptably low.
The discovery of breast cancer among women between 40-49 averages about one saved life for every 1,904 women examined**. Not exactly a mandate for yearly exams in that age group, but what if you were that 1-in-1,904. Or your wife? Or your mother? There are issues of false positives, which may result in unnecessary treatments, but false positives permeate cancer detection research in all phases and at all ages. The percentage of false positives in this age group is no higher than with any other age group.
Time will tell if this announcement – despite the controversy and the back-pedaling – will result in fewer clinical breast exams in the affected age group (or across the board, even).
The fear is that this is the first wave of the new health care plan being considered on Capitol Hill is that women are being set up as the shock troops for a new era of reckless health care policies. Many legislators have promised their constituents that health screenings for cancer and other deadly diseases will never be put on the auction block, that the decision to undergo a screening will always between a doctor and patient.
Let us hope they can hold the fort on that one. Because if they can’t, health insurance, in whatever form it morphs into in the coming years, will likely pay only for screenings that are in accordance with the current recommendations. If a women wants to have a mammography more often than that, she will have to pay for it herself. The upshot of that is that only affluent women will be examined on a yearly basis, that women in the low-income brackets, already the most at risk, will be the ones to suffer.
In the meantime, we all need to strive to educate ourselves on health screenings, risk factors, vaccines and risk reduction procedures of all types. Rumors and “friend-of-a-friend” horror stories about false positives, misdiagnoses, about vaccines run amuck (as with the H1N1 vaccine panic) and amateur opinions about health care should be deep-sixed and replaced with facts.
* http://www.cancer.org/downloads/STT/F861009_final%209-08-09.pdf
**http://www.chicagotribune.com/news/columnists/chi-oped1206chapmandec06,0,7770340.column
I totally agree with you that it will only give procrastinating women more reason than ever to not get examined. My 74 year old mom (never had a mammogram) stated, “See I was right all along.” Duh.
Our TV station recently did a series of “ambush” health care stories, where we talked to people on the streets and got them to submit to free health screenings while the cameras rolled. One gentleman was found to have 80 percent blockage in one of his main arteries, and he didn’t even know it. He ended up having bypass surgery, which probably saved his life. A woman we interviewed was found to have similar issues, but convincing her to seek treatment took a whole lot of doing. Why do people reject sound, proven medical advice? It’s a mystery to me.