U.S. breast cancer screening advice

[lostinblue 1,989]

Is this just the start of our new soon to be medical system . On our local talk show the hour was filled by women who were more than a little upset over the "new" guidelines. Caller after caller cited people they knew who had this cancer in their 30's and 40's. More than one caller mentioned that they feel this is how this new cost reduction will be accomplished in the health care bill. Just preform test less often in a rationed setting.

http://www.google.com/hostednews/canadianp...4xioym_s-qhJX3A

A controversy brewing over new breast cancer screening guidelines in the United States may have sparked confusion among some Canadian women.

But the Canadian Cancer Society says U.S. recommendations have now been brought in line with what experts in Canada have been telling women to do for some time.

The U.S. Preventive Services Task Force is recommending against women in their 40s having routine mammograms because false positives can lead to unnecessary biopsies, while not improving the overall odds of survival.

[Dan J 277]

Is this just the start of our new soon to be medical system . On our local talk show the hour was filled by women who were more than a little upset over the "new" guidelines. Caller after caller cited people they knew who had this cancer in their 30's and 40's. More than one caller mentioned that they feel this is how this new cost reduction will be accomplished in the health care bill. Just preform test less often in a rationed setting.

http://www.google.com/hostednews/canadianp...4xioym_s-qhJX3A

A controversy brewing over new breast cancer screening guidelines in the United States may have sparked confusion among some Canadian women.

But the Canadian Cancer Society says U.S. recommendations have now been brought in line with what experts in Canada have been telling women to do for some time.

The U.S. Preventive Services Task Force is recommending against women in their 40s having routine mammograms because false positives can lead to unnecessary biopsies, while not improving the overall odds of survival.

Here is the issue with these type of tests.

Diseases like cancer are often a result of genetics and environment. If we test everyone, even those who are at low risk for a particular disease. The cost of testing will likely outweigh the money saved by catching the disease early.

The benefit of testing everyone does mean that those who may not be aware of their risk factors might, if they develop the disease, get caught earlier and have a much better survival rate.

Like most types of cancer screening, it will be much more effective if targeted at the highest risk populations. And only targeted at other populations if there are other mitigating factors.

[Niels Bohr 72]

I'm opening an office downtown for free breast screening. In order to qualify for free screening, you must not have STDs, in good physical fitness, blonde, busty, sexy, and beautiful. Please come to my office. I garunteed that you will get examined thoroughly.

[HAL 9000 96]

And the partisan hoopla is (unsurprisingly) ignoring that these are NOT binding medical guidelines. Too bad cost cutting is what really drove this panel to reverse course on the previous panel's recommendations back in 2002.

Significant for something like 1 in 1900 real positive screens is high enough for me to want my wife and mother to get screened anyway, regardless of the guidelines. That's a personal choice, and still likely to be covered as coverage is based on what constitutes rational medical decisions made by physicians attending to patients based on risk and signs.

[raymaga 25]

The first thing that came to my mind was that the "reasoning" for the guidelines for mammograms is definitely related to saving money.

That's very sad, but it's probably just the beginning of what's yet to come with health reform.

[HAL 9000 96]

Recommendations are not binding guidelines.

[Aubrey 10]

I listened to a doctor talk about this on NPR. He explained that a recent study showed that the existing guidelines that recommended early mammography and self-breast exams did not reduce mortality related to breast cancer. He was explaining that if a woman does find a lump, let your doctor know about it immediately but that women were getting more biopsies due to self-breast exams and unless at an unusually high risk (such as a genetic tie to this cancer), women were being exposed to radiation from mammography earlier than necessary (putting them at potential higher risk than necessary).

I really don't think these guidelines are based on money after listening to this doctor.

This is the NPR story I'm referring to:

Doctor Backs New Breast Cancer Guidelines

[Mr. Big Dog 10,747]

But the Canadian Cancer Society says U.S. recommendations have now been brought in line with what experts in Canada have been telling women to do for some time.

The U.S. Preventive Services Task Force, a panel of independent experts, released revamped recommendations this week, including advice that women in their 40s should not have routine mammograms because there is no evidence they improve survival in that age group.

"It's very encouraging to see that their recent review of the evidence is in line with what we've been recommending to Canadian women," said Heather Chappell, director of cancer control policy at the Canadian Cancer Society.

"Certainly we think that all women in their 40s should talk to their doctors about their breast cancer risk and find out if screening is right for them and have a discussion with their doctor about the benefit and harms of screening in this age group," Chappell said Tuesday.

"And we certainly do recommend that women 50 to 69 have mammograms every two years because we know that there is benefit in that age group."

So, the recommendation is to align the screening with widely accepted international standards which Canada, for example, has been following for years. Looking at the outcome, it would appear that the aggressive testing done in the US to date has little, if any, actual benefit.

Breast Cancer Mortality Rate Canada: 20.9

Breast Cancer Mortality Rate USA: 20.7

But yeah, let's call it rationing of health care. Let's be good scaremongers. At the end of the day, the excessive tests and procedure based system, which the fee-for-service remuneration system encourages, is not sustainable. If evidence shows that little, if any, benefit is to be had from excessive tests and screenings, then it would seem rational and prudent to adjust the screening guidelines to adopt a more efficient approach.

[Joseph & Ana 0]

I listened to a doctor talk about this on NPR. He explained that a recent study showed that the existing guidelines that recommended early mammography and self-breast exams did not reduce mortality related to breast cancer. He was explaining that if a woman does find a lump, let your doctor know about it immediately but that women were getting more biopsies due to self-breast exams and unless at an unusually high risk (such as a genetic tie to this cancer), women were being exposed to radiation from mammography earlier than necessary (putting them at potential higher risk than necessary).

I really don't think these guidelines are based on money after listening to this doctor.

This is the NPR story I'm referring to:

Doctor Backs New Breast Cancer Guidelines

I've heard from many other doctor's and non-profit cancer associations that this is total BS. Also the beginning of groundword for rationed care.

[Mr. Big Dog 10,747]

I listened to a doctor talk about this on NPR. He explained that a recent study showed that the existing guidelines that recommended early mammography and self-breast exams did not reduce mortality related to breast cancer. He was explaining that if a woman does find a lump, let your doctor know about it immediately but that women were getting more biopsies due to self-breast exams and unless at an unusually high risk (such as a genetic tie to this cancer), women were being exposed to radiation from mammography earlier than necessary (putting them at potential higher risk than necessary).

I really don't think these guidelines are based on money after listening to this doctor.

This is the NPR story I'm referring to:

Doctor Backs New Breast Cancer Guidelines

I've heard from many other doctor's and non-profit cancer associations that this is total BS. Also the beginning of groundword for rationed care.

That's a BS argument. Care is always rationed. Check your insurance policy and see what it will and won't cover. If there was no rationing in breast cancer screening today, women of all ages could have screenings on a daily basis. Good luck getting re-imbursed for that under your current policy.

[SMR 368]

I listened to a doctor talk about this on NPR. He explained that a recent study showed that the existing guidelines that recommended early mammography and self-breast exams did not reduce mortality related to breast cancer. He was explaining that if a woman does find a lump, let your doctor know about it immediately but that women were getting more biopsies due to self-breast exams and unless at an unusually high risk (such as a genetic tie to this cancer), women were being exposed to radiation from mammography earlier than necessary (putting them at potential higher risk than necessary).

I really don't think these guidelines are based on money after listening to this doctor.

This is the NPR story I'm referring to:

Doctor Backs New Breast Cancer Guidelines

I've heard from many other doctor's and non-profit cancer associations that this is total BS. Also the beginning of groundword for rationed care.

That's a BS argument. Care is always rationed. Check your insurance policy and see what it will and won't cover. If there was no rationing in breast cancer screening today, women of all ages could have screenings on a daily basis. Good luck getting re-imbursed for that under your current policy.

Of course it's always rationed. The point is, we don't want or trust the government to do this rationing. And no, I don't want the insurance company to do it either. Just because I'm opposed to Obamacare doesn't mean I like insurance companies. It means I don't think Obama would be better.

Meaningful healthcare reform means that people have choices. As many have pointed out and some liberals have admitted, Obamacare is designed to push us towards a single-payer system. Single payer is not choices. The government will decide what it will pay for and your only option is do the procedure or not.

[Mr. Big Dog 10,747]

I listened to a doctor talk about this on NPR. He explained that a recent study showed that the existing guidelines that recommended early mammography and self-breast exams did not reduce mortality related to breast cancer. He was explaining that if a woman does find a lump, let your doctor know about it immediately but that women were getting more biopsies due to self-breast exams and unless at an unusually high risk (such as a genetic tie to this cancer), women were being exposed to radiation from mammography earlier than necessary (putting them at potential higher risk than necessary).

I really don't think these guidelines are based on money after listening to this doctor.

This is the NPR story I'm referring to:

Doctor Backs New Breast Cancer Guidelines

I've heard from many other doctor's and non-profit cancer associations that this is total BS. Also the beginning of groundword for rationed care.

That's a BS argument. Care is always rationed. Check your insurance policy and see what it will and won't cover. If there was no rationing in breast cancer screening today, women of all ages could have screenings on a daily basis. Good luck getting re-imbursed for that under your current policy.

Of course it's always rationed. The point is, we don't want or trust the government to do this rationing. And no, I don't want the insurance company to do it either. Just because I'm opposed to Obamacare doesn't mean I like insurance companies. It means I don't think Obama would be better.

Meaningful healthcare reform means that people have choices. As many have pointed out and some liberals have admitted, Obamacare is designed to push us towards a single-payer system. Single payer is not choices. The government will decide what it will pay for and your only option is do the procedure or not.

First of all, single payer is not on the table. Any claim to the contrary earns you a tin foil hat and not much more. That said, the only way for you to avoid rationing of any kind is to pay out-of-pocket for whatever care you want. Otherwise, you'll be faced with rationing whether that rationing is based on maximizing profit or based on comparative effectiveness analysis. Personally, I'd take the latter over the former any day of the week and twice on Sundays. Why? Because the latter is focused on the most effective care (i.e. on me and my health) while the former is focused on the bottom line of the insurance carrier with my health just being an inconvenient cost component.

[SMR 368]

I listened to a doctor talk about this on NPR. He explained that a recent study showed that the existing guidelines that recommended early mammography and self-breast exams did not reduce mortality related to breast cancer. He was explaining that if a woman does find a lump, let your doctor know about it immediately but that women were getting more biopsies due to self-breast exams and unless at an unusually high risk (such as a genetic tie to this cancer), women were being exposed to radiation from mammography earlier than necessary (putting them at potential higher risk than necessary).

I really don't think these guidelines are based on money after listening to this doctor.

This is the NPR story I'm referring to:

Doctor Backs New Breast Cancer Guidelines

I've heard from many other doctor's and non-profit cancer associations that this is total BS. Also the beginning of groundword for rationed care.

That's a BS argument. Care is always rationed. Check your insurance policy and see what it will and won't cover. If there was no rationing in breast cancer screening today, women of all ages could have screenings on a daily basis. Good luck getting re-imbursed for that under your current policy.

Of course it's always rationed. The point is, we don't want or trust the government to do this rationing. And no, I don't want the insurance company to do it either. Just because I'm opposed to Obamacare doesn't mean I like insurance companies. It means I don't think Obama would be better.

Meaningful healthcare reform means that people have choices. As many have pointed out and some liberals have admitted, Obamacare is designed to push us towards a single-payer system. Single payer is not choices. The government will decide what it will pay for and your only option is do the procedure or not.

First of all, single payer is not on the table. Any claim to the contrary earns you a tin foil hat and not much more. That said, the only way for you to avoid rationing of any kind is to pay out-of-pocket for whatever care you want. Otherwise, you'll be faced with rationing whether that rationing is based on maximizing profit or based on comparative effectiveness analysis. Personally, I'd take the latter over the former any day of the week and twice on Sundays. Why? Because the latter is focused on the most effective care (i.e. on me and my health) while the former is focused on the bottom line of the insurance carrier with my health just being an inconvenient cost component.

I realize that single payer is not presently on the table or in the bill. But a government option with associated tax incentives is designed to force private health insurance companies out of business and lead to de-facto single payer system. Obama is on the record stating that he supports single payer. Other liberals are on the record stating that a government system will lead to single payer and follow that up with a "what's so bad about that?" There was a thread on VJ a while back citing a Democrat in congress who admitted this. While bringing tin foil hats into this discussion may sound witty to you, it doesn't make your argument any more or less true.

Rationing based on maximizing profit is not as evil as you seem to think, particularly in a truly free-market (Over regulation currently leads to monopolies in health care). It's called competition. If health insurance companies were really ripping people, other companies could compete and offer better deals.

[Mr. Big Dog 10,747]

I listened to a doctor talk about this on NPR. He explained that a recent study showed that the existing guidelines that recommended early mammography and self-breast exams did not reduce mortality related to breast cancer. He was explaining that if a woman does find a lump, let your doctor know about it immediately but that women were getting more biopsies due to self-breast exams and unless at an unusually high risk (such as a genetic tie to this cancer), women were being exposed to radiation from mammography earlier than necessary (putting them at potential higher risk than necessary).

I really don't think these guidelines are based on money after listening to this doctor.

This is the NPR story I'm referring to:

Doctor Backs New Breast Cancer Guidelines

I've heard from many other doctor's and non-profit cancer associations that this is total BS. Also the beginning of groundword for rationed care.

That's a BS argument. Care is always rationed. Check your insurance policy and see what it will and won't cover. If there was no rationing in breast cancer screening today, women of all ages could have screenings on a daily basis. Good luck getting re-imbursed for that under your current policy.

Of course it's always rationed. The point is, we don't want or trust the government to do this rationing. And no, I don't want the insurance company to do it either. Just because I'm opposed to Obamacare doesn't mean I like insurance companies. It means I don't think Obama would be better.

Meaningful healthcare reform means that people have choices. As many have pointed out and some liberals have admitted, Obamacare is designed to push us towards a single-payer system. Single payer is not choices. The government will decide what it will pay for and your only option is do the procedure or not.

First of all, single payer is not on the table. Any claim to the contrary earns you a tin foil hat and not much more. That said, the only way for you to avoid rationing of any kind is to pay out-of-pocket for whatever care you want. Otherwise, you'll be faced with rationing whether that rationing is based on maximizing profit or based on comparative effectiveness analysis. Personally, I'd take the latter over the former any day of the week and twice on Sundays. Why? Because the latter is focused on the most effective care (i.e. on me and my health) while the former is focused on the bottom line of the insurance carrier with my health just being an inconvenient cost component.

I realize that single payer is not presently on the table or in the bill. But a government option with associated tax incentives is designed to force private health insurance companies out of business and lead to de-facto single payer system. Obama is on the record stating that he supports single payer. Other liberals are on the record stating that a government system will lead to single payer and follow that up with a "what's so bad about that?" There was a thread on VJ a while back citing a Democrat in congress who admitted this. While bringing tin foil hats into this discussion may sound witty to you, it doesn't make your argument any more or less true.

Rationing based on maximizing profit is not as evil as you seem to think, particularly in a truly free-market (Over regulation currently leads to monopolies in health care). It's called competition. If health insurance companies were really ripping people, other companies could compete and offer better deals.

They could do that today but don't. And they won't unless they have to. Open your eyes, man.

[Dan J 277]

I listened to a doctor talk about this on NPR. He explained that a recent study showed that the existing guidelines that recommended early mammography and self-breast exams did not reduce mortality related to breast cancer. He was explaining that if a woman does find a lump, let your doctor know about it immediately but that women were getting more biopsies due to self-breast exams and unless at an unusually high risk (such as a genetic tie to this cancer), women were being exposed to radiation from mammography earlier than necessary (putting them at potential higher risk than necessary).

I really don't think these guidelines are based on money after listening to this doctor.

This is the NPR story I'm referring to:

Doctor Backs New Breast Cancer Guidelines

I've heard from many other doctor's and non-profit cancer associations that this is total BS. Also the beginning of groundword for rationed care.

That's a BS argument. Care is always rationed. Check your insurance policy and see what it will and won't cover. If there was no rationing in breast cancer screening today, women of all ages could have screenings on a daily basis. Good luck getting re-imbursed for that under your current policy.

Of course it's always rationed. The point is, we don't want or trust the government to do this rationing. And no, I don't want the insurance company to do it either. Just because I'm opposed to Obamacare doesn't mean I like insurance companies. It means I don't think Obama would be better.

Meaningful healthcare reform means that people have choices. As many have pointed out and some liberals have admitted, Obamacare is designed to push us towards a single-payer system. Single payer is not choices. The government will decide what it will pay for and your only option is do the procedure or not.

First of all, single payer is not on the table. Any claim to the contrary earns you a tin foil hat and not much more. That said, the only way for you to avoid rationing of any kind is to pay out-of-pocket for whatever care you want. Otherwise, you'll be faced with rationing whether that rationing is based on maximizing profit or based on comparative effectiveness analysis. Personally, I'd take the latter over the former any day of the week and twice on Sundays. Why? Because the latter is focused on the most effective care (i.e. on me and my health) while the former is focused on the bottom line of the insurance carrier with my health just being an inconvenient cost component.

I realize that single payer is not presently on the table or in the bill. But a government option with associated tax incentives is designed to force private health insurance companies out of business and lead to de-facto single payer system. Obama is on the record stating that he supports single payer. Other liberals are on the record stating that a government system will lead to single payer and follow that up with a "what's so bad about that?" There was a thread on VJ a while back citing a Democrat in congress who admitted this. While bringing tin foil hats into this discussion may sound witty to you, it doesn't make your argument any more or less true.

Rationing based on maximizing profit is not as evil as you seem to think, particularly in a truly free-market (Over regulation currently leads to monopolies in health care). It's called competition. If health insurance companies were really ripping people, other companies could compete and offer better deals.

Might be true if there actually was competition. The fact is most people get only one choice from their employer. Ending employer sponsored health insurance would be too disruptive to have any chance of actually passing.