Last Monday a government task force came out with an opposition to the American Cancer Society's long-standing position that women in their 40's should be getting annual mammograms. The new recommendation states that women should begin getting mammograms at age 50 and limit them to every other year. These guidelines were issued by the U.S. Preventive Services Task Force, whose stance influences coverage of screening tests by Medicare and many insurance companies. This panel of doctors and scientists, that did not include ANY oncologists, concluded that getting screened for breast cancer so early and so often leads to too many false alarms and unneeded biopsies without substantially improving women's odds of survival.
As a woman and a physican, this is a personal issue. While I felt that yearly exams were a bit excessive and was also aware of the need for the healthcare system to be cost conscious, prevention and early detection is key to longevity and quality of life.
One of the most important things to come out of this current debate is that these types of global directives force every one of us to begin asking important questions when our health is at issue. Here are some questions to be asked regarding mammograms:
-Who was involved in the funding of the study? Who performed the data analysis. Is there a conflict of interest?
- Where did the initial criteria for testing that we have been following for the last 20 years come from and what is triggering the need for change? Is it valid to review current guidelines or is it financially motivated?
- What about radiation exposure? Is this a major issue for women who are being tested on a yearly basis?
Should women at the highest risk follow the same guidelines as outlined in this study as woman not considered to be at risk?
- How and/or will insurance companies immediately adopt these guidelines and what will or will not be covered moving forward?
This is a debate that will likely drag on for many years to come. As an advocate for patients and their right to get the proper diagnosis, I encourage the government, healthcare providers, women's advocacy groups and other concerned citizens to continue to offer up their comments, contact their local government officials and ask a lot of questions. While it is an emotional subject, the data and facts should be presented for all, directly and indirectly involved, to evaluate.
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