Wednesday, November 18, 2009

Another Breast-Cancer Bombshell Lands Amidst The Health-Care Reform Debate

Hard on the heels of a study revealing that the benefits of breast cancer screenings have been overstated and risk overtreating small cancers while missing cancers that are deadly comes another earthquake: Most women should start regular screenings at age 50, not 40, women age 50 to 74 should have mammograms every two years, rather than every year, and self-breast examinations are not what they're cracked up to be.

These latest findings are from a different research group than that which had earlier studied the benefits of screenings for the American Cancer Society, but like that study found the benefits of mammograms have been overstated in light of the fact that more women are dying for breast cancer-related reasons despite the increasingly sophisticated screenings that they undergo.
Both studies are political hot potatoes coming as they do amidst the debate over health-care reform.
Researchers worry that the new report will be interpreted as a political effort by the Obama administration to save money on health-care costs. There also is the question of how many women -- as well as doctors -- long schooled in the benefits of mammograms and getting annual screenings will follow the new recommended guidelines.

Many women do not think screenings can be harmful although medical experts now say the risks are real. This is because screenings can trigger unnecessary further tests like biopsies, invasive radiation treatments and painful needle biopsies.

The surgeries that often result are a multi-billion dollar industry that gets filthy rich on overdiagnoses. Then there's this: Too many women who have been treated for breast cancer cannot get health insurance or are dropped by their insurers. Being a woman can be a pre-existing condition in and of itself, of course, while having breast cancer is often a health-insurance knockout punch.

The second study was by the United State Preventive Services Task Force.

The task force, an independent panel of experts in prevention and primary care appointed by the federal Department of Health and Human Services, had recommended just seven years ago 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's new rationale about breast self-examinations is that there is no evidence that they yield significant medical benefits. Large studies in Russia and China found no difference in mortality rates between women assigned to perform self-exams and those who aren't.

Some breast cancer organizations are highly critical of the task force report, asserting that more lives will be lost because of later and fewer screenings. American women have the highest incidence rates of breast cancer in the world, 144 per 1,000 among white woman and 122 per 1,000 among African American women, although those rates have been declining in recent years.

18 Comments:

Blogger Moses said…

Well, if we're over-treating it would stand to reason that we're also (almost certainly) mis-diagnosing with false-positives created in the zeal to find and eradicate cancer (and get the new Mercedes), because, let's face it, oncologists find cancer in everything... So, to me, it would be quite rational that we would have the "highest rate in the world."

I know it may shock many, buy significant portions of the medical profession are only in it for the money. And they really don't give a damn who they hurt with their over-aggressive treatment strategy. Just as long as they get paid...

8:53 AM  
Anonymous Anonymous said…

I can imagine what a field day trial lawyers will have with this. I am also shocked and appalled that physicians would order unneeded tests.
An intersting question to me would be why is our reported rate of this cancer so much higher? What is this number comprised of ? Diagnosed? Biopsied? post mortem?

11:57 AM  
Blogger Shaun Mullen said…

Anonymous:

From available evidence, the short answer as to why American women -- indeed, Western women in general -- have higher breast cancer rates than their counterparts in Asian and Africa is diet.

The American diet is centered on animal products, which tend to be high in fat and low in other important nutrients. The fat content of the average American diet is in the range of 37 to 40 percent of calories.

Simply put, the U.S. and countries with a higher intake of fat, especially animal fat, have a higher incidence of breast cancer.

More here:

http://www.cancerproject.org/survival/cancer_facts/breast.php

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