ObamaCare preview: no mammograms for women under 50
I am not making this up.
Women in their 40s should stop routinely having annual mammograms and older women should cut back to one scheduled exam every other year, an influential federal task force has concluded, challenging the use of one of the most common medical tests.
[...]
“Tens of thousands of lives are being saved by mammography screening, and these idiots want to do away with it,” said Daniel B. Kopans, a radiology professor at Harvard Medical School. “It’s crazy — unethical, really.”
Now, now, Dr. Kopans. You’re probably just a shill for the radiology special interest group. You’ve been ripping off the people for too long. It’s about time we stop the rampant over-prescription of mammograms!
And on a totally unrelated note, it would be a great cost control!
Some questioned whether the new guidelines were designed more to control spending than to improve health. In addition to prompting fewer doctors to recommend mammograms to their patients, they worried that the move would prompt insurers to deny coverage for many mammograms.
The new recommendations took on added significance because under health-care reform legislation pending in Congress, the conclusions of the 16-member task force would set standards for what preventive services insurance plans would be required to cover at little or no cost.
But it’s not about rationing! It’s about saving women from temporary anxiety over false positives. And if other women have to die of breast cancer to prevent that anxiety, well, that’s a small price to pay.
Mammograms produce false-positive results in about 10 percent of cases, causing anxiety and often prompting women to undergo unnecessary follow-up tests, sometimes-disfiguring biopsies and unneeded treatment, including surgery, radiation and chemotherapy.
On the bright side, the more women who die in their 40’s and 50’s, the less underfunded Social Security and Medicare will be.
Change we can believe in!
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November 17th, 2009 at 7:52 am
. . . unless you have private insurance.
November 17th, 2009 at 8:50 am
I am not making this up. – Poli
But you are being disingenuous.
From the link:
In its first reevaluation of breast cancer screening since 2002, the independent government-appointed panel recommended the changes, citing evidence that the potential harm to women having annual exams beginning at age 40 outweighs the benefit.
Several patient advocacy groups and many breast cancer experts welcomed the new guidelines, saying they represent a growing recognition that more testing, exams and treatment are not always beneficial and, in fact, can harm patients.
A spectrum of women’s health advocates, breast cancer experts and public health researchers praised the new guidelines.
Petitti stressed that the task force is not recommending against mammography, but that it hopes the new guidelines will lead more women to make their decisions based on their personal circumstances.
Those at high risk because of a family history of breast cancer, for example, or those who are simply more worried about the disease might still opt to have annual screenings, she said.
Maybe if you had read the article, ODS wouldn’t have gotten the best of you.
November 17th, 2009 at 9:39 am
Mike, you are missing the point. Based on these potential new standards…
“…the conclusions of the 16-member task force would set standards for what preventive services insurance plans would be required to cover at little or no cost.”
the result is more financial participation by women who are in their 40’s and younger who desire to take this preventive medical exam. This is the point I believe. People make decisions based on the potential financial burden something presents, including preventive medical services. This will result in fewer at risk women being diagnosed early.
Whether or not women decide to take the test is not the issue being raised by WCV’s posting.
Obama has been touting proactive preventive medical care, but if this becomes the new standards then all women lose IMO.
November 17th, 2009 at 9:42 am
Mike, perhaps you can show me where the article demonstrates that the process of undergoing a mammogram harms women, because it is a given that fewer tests for cancer WILL lead to women encountering the ultimate harm, death. Or is that acceptable to you to assuage those who are somehow ‘harmed’ by false positives. Are you so obtuse you believe death for those denied testing to be preferrable to making sure we protect those poor souls who can’t deal with the good news that they don’t have cancer?
November 17th, 2009 at 10:41 am
And so it begins!
November 17th, 2009 at 10:50 am
Mike:
You took quite a beatdown. Don’t feel bad. Its happened to quite a few lefties on this board.
November 17th, 2009 at 11:28 am
Made a mistake. Not a Poli post.
Rafael, I didn’t miss the point. The article addresses a study that states routine mammograms are unnecessary. Key word being “routine.”
Obama has indeed been touting preventative care but has also equally stressed the need to reduce medical costs.
My overall point is that the article isn’t anywhere near a apocalyptic as WCV makes it out to be.
Doubled:
For every 1,000 women screened beginning at age 40, the modeling suggested that just about 0.7 deaths from breast cancer would be prevented, while about 470 additional women would receive a false-positive result and about 33 more would undergo unnecessary biopsies.
Doubled, this is a study that was conducted. What insurance companies do with the information is another matter. But, if you’re really concerned about people being denied coverage, I suggest you contact your elected officials and demand some kind of reform because many people are denied life saving care every day.
November 17th, 2009 at 11:59 am
Mike:
I think the study needs a little refining
“For every 1,000 women screened beginning at age 40, the modeling suggested that just about 0.7 deaths from breast cancer would be prevented, while about 470 additional women would receive a false-positive result”
So, mammograms provide a false positive for every 1 out 2 women that take the test? Sounds a little high, no? Remember, this is a highly respected group of 16 government bureaucrats.
LOL.
November 17th, 2009 at 12:49 pm
I think the study needs a little refining – Ken
Possible. Did find the recommendation here.
From the recommendation:
The U.S. Preventive Services Task Force (USPSTF) makes recommendations about preventive care services for patients without recognized signs or symptoms of the target condition.
It bases its recommendations on a systematic review of the evidence of the benefits and harms and an assessment of the net benefit of the service.
The USPSTF recognizes that clinical or policy decisions involve more considerations than this body of evidence alone. Clinicians and policymakers should understand the evidence but individualize decision making to the specific patient or situation.
Nothing in the reccomendation states “no mammograms for those under 50″ as the post title suggests.
Those 16 government bureaucrats the require mocking:
1. Ned Calonge, MD, MPH, Chair (Colorado Department of Public Health and Environment)
2. Diana B. Petitti, MD, MPH, Vice-Chair (Arizona State University)
3. Thomas G. DeWitt, MD (Children’s Hospital Medical Center, Cincinnati, Ohio)
4. Allen J. Dietrich, MD (Dartmouth Medical School)
5. Kimberly D. Gregory, MD, MPH (Cedars-Sinai Medical Center)
6. David Grossman, MD (Group Health Cooperative)
7. George Isham, MD, MS (HealthPartners)
8. Michael L. LeFevre, MD, MSPH (University of Missouri School of Medicine)
9. Rosanne M. Leipzig, MD, PhD (Mount Sinai School of Medicine)
10. Lucy N. Marion, PhD, RN (School of Nursing, Medical College of Georgia)
11. Bernadette Melnyk, PhD, RN (Arizona State University College of Nursing & Health Innovation)
12. Virginia A. Moyer, MD, MPH (Baylor College of Medicine)
13. Judith K. Ockene, PhD (University of Massachusetts Medical School)
14. George F. Sawaya, MD (University of California, San Francisco)
15. J. Sanford Schwartz, MD (University of Pennsylvania Medical School and the Wharton School)
16. Timothy Wilt, MD, MPH (University of Minnesota Department of Medicine and Minneapolis Veterans Affairs Medical Center)
November 17th, 2009 at 3:47 pm
Let the healthcare rationing begin!
November 17th, 2009 at 4:03 pm
That will teach those evil insurance companies to make 3% profit, and those evil doctors to cut off feet and take out tonsils for no reason other than money!
November 17th, 2009 at 4:05 pm
Look at all the lefties on the board:
Nothing to see here, nope, no rationing of any kind, never, why would anyone think that.
And you know if any R had made the same proposal : “Bastard! Haliburton is behind this! All because Cheney doesn’t have enough money!”
November 17th, 2009 at 7:33 pm
Textbook Obama Hatred Syndrome.
November 17th, 2009 at 7:56 pm
lol douchebag
November 18th, 2009 at 7:03 am
I think your party spokesperson, Sarah Palin, needs to put her head in a mammogram machine to see what the hell is growing (or not) up there….what a friggin’ braindead loon!
Your Party Spokesperson.
November 18th, 2009 at 9:26 am
I think your party spokesperson, Nancy Pelosi, needs to put her head in a mammogram machine to see what the hell is growing (or not) up there….what a friggin’ braindead loon!
Your Party Spokesperson.
November 18th, 2009 at 9:44 am
I agree those stats are a little confusing. But look at it this way — women in their twenties get breast cancer too, and early screening would help prevent some of their deaths. Does this mean it is worth the cost to screen all women over twenty? I don’t think so. Yes this is rationing, but some rationing is necessary to prevent constant screening and unnecessary treatments. As to whether the age should be 50 or 40 (or anything else), I have no clue. Still, we shouldn’t disregard the results simply because it means less screening.
November 18th, 2009 at 12:33 pm
Mike:
“Those 16 government bureaucrats the require mocking:”
Oh boy, worse than I thought. Here we have 16 fully employed geographically diverse board members who somehow worked closely together to develop an absurd conclusion. What did they do, all fly into Boca Raton on weekends to do basic research?
These “Blue Ribbon” panels are a joke. Unfortunately, a bad joke.
November 18th, 2009 at 12:56 pm
So now every Republican has better judgement on woman’s health than a panel of medical experts and doctors….man, you people are quite the lethal mixture of self-delusion and partisan hatred.
Marvin, Sarah Palin has the intellectual maturity of a 6 year old brat….Nancy Pelosi puts her to shame. If you think the comparison is equivalent, you’ve obviously not been paying much attention to what and how each of them express themselves.
November 18th, 2009 at 1:16 pm
fly into Boca Raton
And here you just flew to a conclusion.
Are your arms tired?
November 18th, 2009 at 1:43 pm
Pluto:
“And here you just flew to a conclusion.”
Sarcasm, Lotus Blossom, sarcasm.
November 18th, 2009 at 1:45 pm
Warner:
“you people are quite the lethal mixture of self-delusion and partisan hatred.”
Still capturing the title of Village Idiot, I see. Keep up the good work.
November 18th, 2009 at 1:58 pm
Ken,
Doesn’t matter if it was a panel of chimps. Nowhere in the article or recommendation does it say anything that resembles “no mammograms for women under 50.”
WCV is, indeed, making it up.
Everything else is speculation on what insurance companies will do. The “rationing” you people are wetting your pants over will come from them. But since profits before people is a noble endeavor, I’m sure wingnuts will readily forgive them.
How Obama got thrown into all this can only be explained by ODS.
November 18th, 2009 at 2:16 pm
sarcasm
Yet true.
November 18th, 2009 at 2:22 pm
Marvin, Sarah Palin has the intellectual maturity of a 6 year old brat….Nancy Pelosi puts her to shame.
This is true if you mean that Pelosi is an ignoramus and intellectual lightweight whose only real gift is using her boney elbows to poke and prod her Donk colleagues to do kowtow to her will.
November 18th, 2009 at 2:23 pm
I think Sarah Palin has been replaced as the top GOP spokesperson by Carrie Prejean, and with good reason Prejean is like Reagan only she looks better in a swimsuit.
I wonder what Prejean thinks about mammograms for women with implants.
Prejean/Palin 2012
November 18th, 2009 at 2:52 pm
Mike:
Read this statement from the report
“For every 1,000 women screened beginning at age 40, the modeling suggested that just about 0.7 deaths from breast cancer would be prevented, while about 470 additional women would receive a false-positive result and about 33 more would undergo unnecessary biopsies.”
Does something appear odd about the “modeling” study? The conclusion they reach is 50% of all mammograms results are wrong. Sound credible? If even a small percentage were true, there would be a mass gold rush by trial lawyers to file damage suits against everyone associated with these tests. It would make the abestos suits look like a walk in the park.
The Blue Ribbon committee should have questioned these results. They were likely too busy cashing their paychecks for all the weekend “work” they performed.
November 18th, 2009 at 4:32 pm
Sound credible?
Possibly, since it is a quote from WaPo. Before you go squawking about Blue Ribbon Committees you should read the published report from this week’s Annals of Internal Medicine:
http://www.annals.org/content/151/10.toc
Lots of stuff there for you to cherry pick a nugget or two in order to discredit the whole lot.
November 18th, 2009 at 4:33 pm
Should be “possibly not”
November 18th, 2009 at 4:53 pm
Prejean/Palin 2012? Prejean might be a little young but they are about the best the GOP has to offer.
November 18th, 2009 at 4:55 pm
Pluto:
“Sound credible?
Possibly, since it is a quote from WaPo”
Thank you.
November 18th, 2009 at 5:10 pm
Thank you.
You are welcome. And so, how are you coming on distancing yourself from relying on WaPo by reading the source report? Here is the link again:
http://www.annals.org/content/151/10.toc
November 18th, 2009 at 6:07 pm
Ken,
That quote is from the article, not the recommendation. The author doesn’t elaborate on the numbers or reference anything specific as to verify. Those statistics don’t appear in the recommendation he is writing about.
Here is a study from the New England Journal of Medicine that addresses false-positives. From this study: The estimated cumulative risk of a false positive result was 49.1 percent after 10 mammograms.
The WaPo article doesn’t state how many mammograms were part of model. Judging by the NEJM study, the 50% from the article would suggest a 10-yr model and would make sense since it’s addressing the 40-49 age group.
Back to my original point: “No mammograms for women under 50″ is a lie.
November 18th, 2009 at 7:14 pm
The Blue Ribbon committee should have questioned these results. They were likely too busy cashing their paychecks for all the weekend “work” they performed.
Ken, here is that link again:
http://www.annals.org/content/151/10.toc
I am looking forward to your analysis of the source report, and not the WaPo version, of the “weekend work” of the “Blue Ribbon Committee”.
Here is a nugget:
“false-positive mammography results are common
in all age groups but are most common among
women aged 40 to 49 years (97.8 per 1000 women per
screening round)”
That is per screening round, Ken, just think of the cumulative rate of false-positives. Regarding that, here is another nugget:
“The cumulative risk for false-positive mammography results has been reported as 21% to 49% after 10 mammography examinations
for women in general (39–41), and up to 56% for
women aged 40 to 49 years (41).”
November 19th, 2009 at 6:21 am
Pluto:
“Ken, here is that link again”
Thanks. When posters such as yourself trumpet their knowledge by pointing to a report that essentially says a coin flip is a better cancer indicator than a mammogram, well……
Don’t quit your day job, bub.
November 19th, 2009 at 6:31 am
coin flip
Uh, Ken, a coin flip is 50/50.
When posters such as yourself trumpet their knowledge
Uh, Ken, I was linking to the report so that YOU could trumpet your knowledge. Since you made caustic generalizations about “Blue Ribbon Committees” doing “weekend work”.
So, step up to the plate and give us your analysis of the report.
November 19th, 2009 at 6:47 am
Pluto:
“Uh, Ken, a coin flip is 50/50.”
Brilliant!
November 19th, 2009 at 6:57 am
Brilliant!
Translation: Ken is stalling and putting forth diversions, since he is unable step up to the plate and give us his analysis of the report.