Government controlled Mammogram "directives"

[Team Sergeant]

Government controlled healthcare, what's the worry? The government knows best. Let me add what an M.D. just said to me, "That just means the "government" will only "pay" for mammograms for those over fifty and only once every two years".

Hope and Change.


New Mammogram Advice Raises Concerns

Tuesday, November 17, 2009


NEW YORK — For many women, getting a mammogram is already one of life's more stressful experiences.

Now, women in their 40s have the added anxiety of trying to figure out if they should even be getting one at all.

A government task force said Monday that most women don't need mammograms in their 40s and should get one every two years starting at 50 — a stunning reversal and a break with the American Cancer Society's long-standing position. What's more, the panel said breast self-exams do no good, and women shouldn't be taught to do them.

The news seemed destined to leave many deeply confused about whose advice to follow.

"I've never had a scare, but isn't it better to be safe than sorry?" asked Beth Rosenthal, 41, sitting in a San Francisco cafe on Monday afternoon with her friend and their small children. "I've heard of a lot of women in their 40s, and even 30s, who've gotten breast cancer. It just doesn't seem right to wait until 50."

Her friend agreed. "I don't think I'll wait," said Leslie David-Jones, also 41, shaking her head.

For most of the past two decades, the American Cancer Society has been recommending annual mammograms beginning at 40, and it reiterated that position on Monday. "This is one screening test I recommend unequivocally, and would recommend to any woman 40 and over," the society's chief medical officer, Dr. Otis Brawley, said in a statement.

But the U.S. Preventive Services Task Force, a government panel of doctors and scientists, concluded that such early and frequent screenings often lead to false alarms and unneeded biopsies, without substantially improving women's odds of survival.

"The benefits are less and the harms are greater when screening starts in the 40s," said Dr. Diana Petitti, vice chair of the panel.

Breast cancer survivors who were diagnosed at a young age were among the more vocal critics of the new guidelines.

"This sure seems like a big step backwards to me," said Debbie Hayes, who was diagnosed with Stage 2 breast cancer at age 33 after finding a lump during a self-exam. A mammogram, ultrasound, biopsy and finally a mastectomy and chemotherapy followed.

"People are being diagnosed even in their early 20s," said Hayes, now 53 and a volunteer coordinator for the Chicago-based Breast Cancer Network of Strength. "Mammograms are a key element of that."

But another breast cancer survivor thought the new guidelines sounded about right — even though she was diagnosed at age 37, two years ago.

"They seem pretty sensible to me," said Claire Mayne, of San Francisco. "The death rate is not going down because of the earlier mammograms. I'd feel comfortable telling a friend to wait until she was 50."

Mayne was more doubtful, though, about the advice on self-exams; that's how she found her own cancer.

Most women in their 40s interviewed for this article said they planned to stick with the old mammography recommendations, at least for now.

"I have two young children," said Amber Smart, a 47-year-old mother in Agoura Hills, Calif. "There's a lot of years left that they need me." She's been having mammograms every six months, since she was 44, to make sure that certain dense areas of her breasts aren't cancer.

"I think it's kind of sad that they're basically saying, 'We can't afford to pay for the few people who may have it in their 40s, so a few people are going to die,"' Smart said.

Judy Finley, a flight attendant from Dallas, called the new re in line with international guidelines, which call for screening to start at age 50; the World Health Organization recommends the test every two years, and Britain says every three years.

They were sharply challenged by the cancer society on Monday.

"The task force advice is based on its conclusion that screening 1,300 women in their 50s to save one life is worth it, but that screening 1,900 women in their 40s to save a life is not, Brawley wrote.

That stance "is essentially telling women that mammography at age 40 to 49 saves lives, just not enough of them," he added.

But Dr. Amy Abernethy of the Duke Comprehensive Cancer Center agreed with the task force's changes.

"Overall, I think it really took courage for them to do this," she said. "It does ask us as doctors to change what we do and how we communicate with patients. That's no small undertaking."

http://www.foxnews.com/story/0,2933,575371,00.html

[Team Sergeant]

And then the American Cancer Society Responds......I do "hope" all of you that voted for "change" like this one..... government controlled "Mammography" healthcare....

Bet all of you saw that coming.....socialist shots are being fired, do you have to wait until one hits you?

TS



American Cancer Society Responds to Changes to USPSTF Mammography Guidelines
The American Cancer Society guidelines will not change; annual mammography recommended for women 40 and over

Atlanta 2009/11/16 -November 16, 2009—The United States Preventive Services Task Force (USPSTF) today announced that it is changing its guidelines for mammography and no longer recommends routine screening for women between the ages of 40 and 49. Below is a statement from Otis W. Brawley, M.D., chief medical officer, American Cancer Society.
“The American Cancer Society continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40. Our experts make this recommendation having reviewed virtually all the same data reviewed by the USPSTF, but also additional data that the USPSTF did not consider. When recommendations are based on judgments about the balance of risks and benefits, reasonable experts can look at the same data and reach different conclusions.

“In 2003, an expert panel convened by the American Cancer Society conducted an extensive review of the data available at the time, which was not substantially different from the data included in the current USPSTF review. Like the USPSTF, the Society’s panel found convincing evidence that screening with mammography reduces breast cancer mortality in women ages 40-74, with age-specific benefits varying depending on the results of individual trials and which trials were combined in meta-analyses. And like the USPSTF, the American Cancer Society panel also found that mammography has limitations – some women who are screened will have false alarms; some cancers will be missed; and some women will undergo unnecessary treatment. These limitations are somewhat greater in women in their forties compared with women in their fifties, and somewhat greater in women in their fifties compared with women in their sixties. We specifically noted that the overall effectiveness of mammography increases with increasing age. But the limitations do not change the fact that breast cancer screening using mammography starting at age 40 saves lives. “As someone who has long been a critic of those overstating the benefits of screening, I use these words advisedly: this is one screening test I recommend unequivocally, and would recommend to any woman 40 and over, be she a patient, a stranger, or a family member.

“The USPSTF says that screening 1,339 women in their 50s to save one life makes screening worthwhile in that age group. Yet USPSTF also says screening 1,904 women ages 40 to 49 in order to save one life is not worthwhile. The American Cancer Society feels that in both cases, the lifesaving benefits of screening outweigh any potential harms. Surveys of women show that they are aware of these limitations, and also place high value on detecting breast cancer early.

“With its new recommendations, the USPSTF is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them. The task force says screening women in their 40s would reduce their risk of death from breast cancer by 15 percent, just as it does for women in their 50s. But because women in their 40s are at lower risk of the disease than women 50 and above, the USPSTF says the actual number of lives saved is not enough to recommend widespread screening. The most recent data show us that approximately 17 percent of breast cancer deaths occurred in women who were diagnosed in their 40s, and 22 percent occurred in women diagnosed in their 50s. Breast cancer is a serious health problem facing adult women, and mammography is part of our solution beginning at age 40 for average risk women.

“The American Cancer Society acknowledges the limitations of mammography, and we remain committed to finding better tests, and currently are funding a large study to improve the accuracy of mammography. In fact, data show the technology used today is better than that used in the studies in this review, and more modern studies show that mammography is achieving better results than those achieved in these early experimental studies that go back as far as the mid-60’s. And as scientists work to make mammography even more effective, the American Cancer Society’s medical staff and volunteer experts overwhelmingly believe the benefits of screening women aged 40 to 49 outweigh its limitations.”

The American Cancer Society combines an unyielding passion with nearly a century of experience to save lives and end suffering from cancer. As a global grassroots force of more than three million volunteers, we fight for every birthday threatened by every cancer in every community. We save lives by helping people stay well by preventing cancer or detecting it early; helping people get well by being there for them during and after a cancer diagnosis; by finding cures through investment in groundbreaking discovery; and by fighting back by rallying lawmakers to pass laws to defeat cancer and by rallying communities worldwide to join the fight. As the nation’s largest non-governmental investor in cancer research, contributing about $3.4 billion, we turn what we know about cancer into what we do. As a result, more than 11 million people in America who have had cancer and countless more who have avoided it will be celebrating birthdays this year. To learn more about us or to get help, call us anytime, day or night, at 1-800-227-2345 or visit cancer.org.

http://www.cancer.org/docroot/MED/co...Guidelines.asp

[abc_123]

TS,

And this is a living, breathing example of how what is described in your signature line happens.

What, no rebellion?

Well... maybe next time.

[Team Sergeant]

Originally Posted by abc_123

TS,

And this is a living, breathing example of how what is described in your signature line happens.

What, no rebellion?

Well... maybe next time.

I like how the "government" used the AMA as a "TOOL" in promoting obamacare/gov run healthcare. Note, most physicains do not belong to the AMA......

Wait until the sheeple find out 90% of the current physicians might not accept "GOV insurance".

"You can keep your current doctor!" (If he or she accepts GOV insurance.)

Change is here.

[PedOncoDoc]

I'd like to see what the government is proposing for women who are considered higher than average risk (due to personal and family history among other things). This important (and substantial) population was not addressed in either article.

I'd also like to see statistics regarding breast cancer from other countries - many variables including air quality, sun/UV exposure and diet which vary based on geographical region and culture have shown to have major impacts on cancer epidemiology. For example, ther Japanese have a mich higher risk for stomach cancer, felt to be due to the large amount of smoked fish in their diet; the payoff is decreased cardiovascular disease.

Also, copmparing our health system's outcomes to those of other nations is comparing apples to oranges. Access to - and quality of health care changes outcomes as well.

[Team Sergeant]

Originally Posted by PedOncoDoc

I'd like to see what the government is proposing for women who are considered higher than average risk (due to personal and family history among other things). This important (and substantial) population was not addressed in either article.

I'd also like to see statistics regarding breast cancer from other countries - many variables including air quality, sun/UV exposure and diet which vary based on geographical region and culture have shown to have major impacts on cancer epidemiology. For example, ther Japanese have a mich higher risk for stomach cancer, felt to be due to the large amount of smoked fish in their diet; the payoff is decreased cardiovascular disease.

Also, copmparing our health system's outcomes to those of other nations is comparing apples to oranges. Access to - and quality of health care changes outcomes as well.

It's all right here:

U.S. Department of Health & Human Services

http://www.ahrq.gov/clinic/uspstf/uspsbrca.htm

[PedOncoDoc]

Originally Posted by Team Sergeant

I like how the "government" used the AMA as a "TOOL" in promoting obamacare/gov run healthcare. Note, most physicains do not belong to the AMA......

Wait until the sheeple find out 90% of the current physicians might not accept "GOV insurance".

"You can keep your current doctor!" (If he or she accepts GOV insurance.)

Change is here.

The AMA is a political platform, just like many other professional organizations. They try to influence how professionals in their field vote en masse. I find it ironic that the AMA is "The American Medican Association" but amongst health care professionals it is more often used in reference to "against medical advice."

I've had long discussions with my brother about government insurance. Any large academic center will be required to accept fgovernment insurance in order to pay the physicians in training at their institutions (who have not seen an increase in salary in over 20 years.) Any "successful" doctor is likely to go into the private sector and demand out-of-pocket or private insuror payments in order to practice medicine in the way they feel is best for ther patient instead of how the government mandates. This will then lead to substandard medical training and a complete and utter breakdown of quality health care in our country.

[Team Sergeant]

This socialistic shot has been heard and some are responding.....



Updated November 17, 2009
Critics See Health Care Rationing Behind New Mammography Recommendations
by
FOXNews.com

Some lawmakers on Capitol Hill are blasting new guidelines from a government task force that recommends against routine mammograms for women under 50, questioning whether they are tantamount to health care "rationing" in the fight against the No. 2 cancer killer in U.S. women.

Some lawmakers on Capitol Hill are blasting new guidelines from a government task force that recommends against routine mammograms for women under 50, questioning whether they are tantamount to health care "rationing" in the fight against the No. 2 cancer killer in U.S. women.

"I absolutely believe this could be a form of rationing," said Rep. Phil Gingrey, R-Ga, a practicing obstetrician and gynecologist for 26 years. "It scares me."

Gingrey told FoxNews.com on Tuesday that he and other lawmakers are gravely concerned that insurance companies will seize upon the new guidelines to deny mammogram coverage for women under 50.

"Early detection is hugely important," Gingrey said, noting that breast self-exams are critical in looking for cancerous tissue masses.

The new government recommendations, released Monday by the Preventive Services Task Force of the Department of Health and Human Services, recommend against regular mammography tests in women aged 40 to 49. The guidelines also downplay the effectiveness of self-examinations and advise that women aged 50 to 74 years receive mammograms every other year.

The U.S. Preventive Services Task Force, a government panel of doctors and scientists, concluded that such early and frequent screenings often lead to false alarms and unneeded biopsies without substantially improving women's odds of survival.

"The benefits are less and the harms are greater when screening starts in the 40s," said Dr. Diana Petitti, vice chairwoman of the panel.

Dr. Eric Braverman, a clinical assistant professor of integrative medicine at Cornell Weill Medical College in New York, also backs the guidelines, arguing that mammographies are not nearly as effective in detection as some other tests, like MRI's and ultrasounds.

"I'm not impressed by mammograms in general," said Braverman, who called manual examinations a "total failure."

"I support the new guidelines because I think it will lead to better testing. [The ultrasound] is a better screening procedure that's safer and easier and picks up things fast," he said, adding that he thinks women should receive ultrasounds as part of their routine medical exams, beginning at an early age.

But critics of the new rules say ignoring the health risk is not worth it. Breast cancer is the second leading cause of cancer deaths among women and the seventh leading cause of death overall for women.

"For every seven to 10 women that are being overdiagnosed or overtreated, we're saving one woman's life and I think for me that's worth it," said Dr. Cynara Commer, a professor of surgery at Mt. Sinai's Surgical Oncology Department in New York.

"That's worth finding that one cancer at early stage as opposed to late stage, and the argument that this is saving cost is sort of irrelevant because if we end up finding cancers at later stages, those women have to go much more aggressive treatment," Commer added.

Kathleen Lederer, 56 of Houston, Texas, first detected her breast cancer through a self-examination when she was 39-year-old. Lederer alerted her physician, who found after performing a mammography and biopsy that she had cancer.

"I would be dead if I waited until 50," Lederer told FoxNews.com, adding that she was "horrified" by the government's latest guidelines.

"Is this just a way to start cutting costs for government-run health care?" she asked.

Rep. Bill Cassidy, R-La., said the new guidelines may discourage a number of women from seeking necessary preventive screening.

"The concern is that many people are not complying now with what is currently recommended," he said. "There is a potential that this is going to confuse women and make them less likely to be treated.

"I prefer to think that this is just not a conspiracy to save costs," Cassidy added.

For most of the past two decades, the American Cancer Society has recommended annual mammograms beginning at 40, and it reiterated that position on Monday.

"This is one screening test I recommend unequivocally, and would recommend to any woman 40 and over," the society's chief medical officer, Dr. Otis Brawley, said in a statement.

Commer said she is very concerned that the new guidelines are the top of a slippery slope toward rationing, and questioned the timing as the Senate is about to vote on health care reforms that could end up containing a so-called public option.

"The government-run insurance companies are definitely going to be using these federal guidelines as opposed to using the American Cancer Society guidelines, and the American Cancer Society is not going along with these guidelines, and we can only hope that the private insurance companies don't follow suit," she said.

"I think it's coming down to saving costs. I don't think we should be doing that at the expense of women," she added.

FoxNews.com's Cristina Corbin and The Associated Press contributed to this report.

http://www.foxnews.com/politics/2009...commendations/

[PedOncoDoc]

"I think it's coming down to saving costs. I don't think we should be doing that at the expense of women," she added.

An idea that would be laughed at by radical Muslims as the speaker was stoned for speaking out of turn in other coutries, but i digress...

Rationing health care is a scary prospect. There are many ways this could be practiced, here are just 3 examples (extreme as they may be):

1. People requiring certain treatments or with certain diagnoses could be turned away because the allotted resources for that fiscal period had been exhausted. Either pay out of pocket or go without.

2. Disease "x" only gets treated in 3 cities; one on each coast and on in the midwest. If you don't live near the treatment center, you need to relocate, leaving everything behind (job, house, mortgage, children's education, moral/emotional support, etc.)) If you aren't willing to do that you don't get treatment or find a private hospital and pay out of pocket.

3. Look at the total expected cost for treatment including an average cost of unexpected complications. If the cost, survival curve and expected productivity after treatment don't match up favorably, don't offer treatment. This would apply to most adult cancers, congenital defects, neurologic disorders, etc.

Any takers?

[abc_123]

Originally Posted by PedOncoDoc

An idea that would be laughed at by radical Muslims as the speaker was stoned for speaking out of turn in other coutries, but i digress...

Rationing health care is a scary prospect. There are many ways this could be practiced, here are just 3 examples (extreme as they may be):

1. People requiring certain treatments or with certain diagnoses could be turned away because the allotted resources for that fiscal period had been exhausted. Either pay out of pocket or go without.

2. Disease "x" only gets treated in 3 cities; one on each coast and on in the midwest. If you don't live near the treatment center, you need to relocate, leaving everything behind (job, house, mortgage, children's education, moral/emotional support, etc.)) If you aren't willing to do that you don't get treatment or find a private hospital and pay out of pocket.

3. Look at the total expected cost for treatment including an average cost of unexpected complications. If the cost, survival curve and expected productivity after treatment don't match up favorably, don't offer treatment. This would apply to most adult cancers, congenital defects, neurologic disorders, etc.

Any takers?

Um.. how about instead of turning them away just drag out the process so that a percentage of the people waiting for the treatment simply elect not to wait any longer.... by dying.

On second thought this would simply be a variation on #1.

[PedOncoDoc]

Originally Posted by abc_123

Um.. how about instead of turning them away just drag out the process so that a percentage of the people waiting for the treatment simply elect not to wait any longer.... by dying.

On second thought this would simply be a variation on #1.

But hey - if it keeps the costs down and it's in a non-voting demographic, it must be good for us, right?

Why did I just have Soylent Green pop up in the back of my mind?