According to a government-appointed panel of prestigious medical experts, one that influences insurers and general practitioners, women should not begin getting breast x-rays until they turn 50, and then only every other year rather than annually. Doctors, the group (the United States Preventive Services Task Force) declares, should not instruct women to examine their breasts for lumps.
All of this reverses years of well-intended advice and public information campaigns by women's health advocates and will raise a firestorm - proving once again that health information and advice is a matter of competing social and political forces. This has been proven time and again by debates and conflict over campaigns and information concerning childhood vaccinations, the health benefits of alcohol, whether addiction is a disease, and legalizing drugs.
Why would this group declare women shouldn't examine their breasts - which seems like a model for women controlling their health and bodies.? (Disclosure: I am not a physician and have no independent medical expertise on the subject of breast cancer prevention and treatment.) Because results of such examinations, data indicate, result overall in more negative outcomes for women, due to false positives with their sequelae. Accurate and helpful information likewise is simply too difficult to obtain from x-raying breast tissue before women turn fifty. (This does not apply to women with family histories of breast cancer.)
Already, the American Cancer Society - which is not a government, but a private organization - objects to these recommendations. Other interest groups concerned with women's health will likewise weigh in, generally with similar opposition. The preventive services panel is too diverse and well-ensconced to suffer professional retributions from creating these recommendations. But they will face criticism and vituperation - often quite personal in nature - for their efforts, even though they are trying to do the best they can for improving women's health and lives.
One component in the panel's evaluation which is foreign to American thinking is "cost-effectiveness." That is, false positives in tests for breast cancer - as well as being uncomfortable, costly, and having potential dangers for the women needlessly tested - subtract health care funds from effective testing and treatments for appropriate populations. These kinds of calculations are typically made in other countries, but are widely rejected here where we instead ask, "Why can't everyone have all the care they want?" Americans have no sense of a limited resources that must be divided up in the best way.
Who says medicine is an objective science?
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