Thursday, November 19, 2009

GOP nonsense about the new mammogram recommendations

“This is the little toe in the edge of the water,” said Representative Marsha Blackburn of Tennessee. “This is where you start getting a bureaucrat between you and your physician.”

This is the Republican reaction to the recommendation of the U.S. Preventive Service Task Force that women between 40 and 50 not receive annual mammograms. The Wall Street Journal piled on, blaming the result on "Obamacare" and cost-cutting. The WSJ article focuses entirely on the fact that by not screening women from 40 to 50, some number of women in that range will not catch a tumor in time. That is true. What the article ignores, however, is what's on the other side of the scale- some serious negative consequences of screening women in that age-range:

The task force advised on Monday that most women should not start routine screening until they are 50, as opposed to the current standard of 40. The reason, according to the task force, is that studies show that “the additional benefit gained by starting screening at age 40 years rather than at age 50 years is small, and that moderate harms from screening remain at any age.”
While the downsides of mammography have not received much attention,
cancer researchers say they are real and include excess biopsies, unnecessary anxiety and the discovery and treatment of tumors that would not cause problems if let alone.

In addition, some research has found that mammograms themselves, because of the radiation dose, lead to an increased risk of cancer.

This line of thinking is not, as the GOP would have you believe, a brand new thing brought on by Obama's desire to heartlessly kill off old people. For years, the American Cancer Society and other groups have recommended that men not be screened for prostate cancer, because screenings lead to unnecessary treatments (radiation therapy and surgery) that are oftentimes more dangerous than the cancers they are treating.

One final point- with all the squawking about how "government bureaucrats are getting in between patients and doctors," you'd think that the task force was made up of federal employees, right? Probably a bunch of unqualified hacks and bean counters sitting around dreaming up ways to screw over patients.

In fact, looking at a list of the members of the panel shows that these are actually pretty qualified people- the Dean of the College of Public Health at U. Iowa, the Director of Women's Health Services Research at Cedars-Sinai Hospital in LA, the Medical Director of HealthPartners Co. in Minneapolis, the Dean of the School of Nursing at the Medical College of Georgia, a professor from Johns Hopkins Medical School, etc. You know, the sort of people who might have a better idea of how to interpret cancer research literature than Congresswoman Blackburn, whose only work experience outside of elected office is selling textbooks door to door.

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