December 02, 2009
Truth Squad: Medical Reporting on Mammograms—Part 2
Part 1 of this post described how the US Preventive Services Task Force’s (USPSTF’s) message about mammograms has been distorted by the press. Despite what you may have read, the Task Force did not recommend that women in their 40’s skip mammograms; it advised them to discuss the risks as well as the benefits with their doctors. And the USPSTF was not trying to save money; it is not charged with cutting the cost of care. Its only goal is to give women full information about the benefits and the limits--of mammography screening.
Below, I explain that what the task force just explained about the risks of mammography is something that it tried to tell us years ago. But Congress stood up and said “No—we don’t want women to know that.” Why? Because lobbyists for those companies who make mammography equipment did not want women to know that mammograms can lead to unnecessary surgery.
Below, I also note that some patient advocates as well as many disinterested physicians applaud the Task Force’s message. It’s just not as controversial as the media pretends. Indeed just one month ago the chief medical officer of the American Cancer Society was questioning the advantages of mammography in the pages of the New York Times.
Finally many in the media have claimed that under reform, the government will use “comparative effectiveness research” to ration care. This is totally untrue. Reform legislation is very clear: neither the USPSTF or any other government agency can use such research to deny coverage.
=========================
See the article for a fuller discussion of the issue.
Part 1 is at :
http://www.healthbeatblog.com/2009/11/truth-squadmedical-reporting-on-mammograms-part-1.html
=========================
A comment from this article:
The other side of the coin is radiation risk imposed by mammography. It is not simply of negligible value in younger women, but may have a net harm effect, if women who have mammograms at age 40 start having higher rates of cancer in irradiated breasts 25 or 35 years later.
The recommendation not to begin mammography until age 50 has to do with medical issues, more than cost effectiveness issues. Mammography is not harmless. You are subjecting women to annual doses of ionizing radiation to the breasts, with some unavoidable scatter to chest wall and lungs. We do not know how many women who are irradiated by mammography in their 40s will develop radiation-induced breast cancer (or even lung cancer) in their 60s, 70s, and 80s.
The fact is that we have no truly long term follow up studies to determine very long term risks of carcinogenesis from radiation exposure in mammography (J Radiol Prot. 2009 Jun;29(2A):A123-32. Epub 2009 May 19).
Posted by: Gregory D. Pawelski | December 03, 2009 at 09:40 PM
No comments:
Post a Comment