Federal task force says women need fewer mammograms. Sound reasoning or rationing?


Bewilderment. That's the only word I can use to describe how I felt upon reading an article in my daily newspaper this morning (Yes, I still read the daily paper). The story reported on an influential federal task force's recommendation that women have fewer mammograms. "We're not saying that women shouldn't get screened. Screening saves lives," said Diana Petitti, vice chairman of the U.S. Preventive Services Task Force. "But we are recommending against routine screening. There are important and serious negatives or harms that need to be considered carefully." The recommendations of this committee would set the standards for preventative health care services under health care reform and would be used to determine which tests would be covered by insurance plans. These guidelines are for the general population, not for those at high risk of breast cancer. The 16-member committee recommended that most women in their 40s should not routinely get mammograms. Additionally, women 50 to 74 should get mammograms every other year until they turn 75, after which the risks and benefits are unknown. Women 75 and older should not get regular screening. The committee is also against teaching women to do regular self exams because "the value of breast exams by doctors is unknown and breast self exams are of no value." Those who side with the task force's findings say that more testing, exams, and treatment are not always beneficial and may cause harm to patients. The article stated that in about 10 percent of cases, false positive results caused anxiety among patients and lead to unnecessary procedures such as disfiguring biopsies and in some cases, surgery, chemotherapy, and radiation. Those on the opposing side said that this is a huge step in the wrong direction. Daniel Kopans, a radiology professor at Harvard Medical School said, "Tens of thousands of lives are being saved by mammography screening, and these idiots want to do away with it." Dr. Phil Evans, director of the Center for Breast Care at UT Southwestern Medical Center in Dallas predicted that conducting fewer mammograms would be a mistake. "Mammography is not a perfect test, but it's still the best test for finding breast cancer early," argued Evans. The most ominous quote in the article came from Dr. Michael Grant, my breast surgeon at Baylor University Medical Center at Dallas. He said that the timing of this made him suspicious. "Ultimately, this may be how we provide rationale for rationing. They're not saying it isn't worth it -- just that the number of lives it saves is not counter balanced by the cost and trouble of doing it," said Grant. Roughly 39 million women in the U.S. have mammograms each year, costing the healthcare system more than $5 billion annually.I think I need to dust off my old copy of George Orwell's, Animal Farm. This arguement is sounding vaguely familiar. "All animals are equal-- just some are more equal than others."

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