ShareThisThe government-funded -- but independent -- U.S. Preventive Service Task Force, made up of 16 physicians and public-health experts, did what it was supposed to, and indeed should be done routinely under any health-care-reform plan, a periodic examination and re-evaluation of current medical practice.
This week the panel released its recommendations following the first re-evaluation of breast-cancer screening since 2002. The findings would have been attention-grabbing at any time, but were especially incendiary coming just as the Senate takes up health-care reform.
In brief, the panel concluded that the potential harm -- false positives, unnecessary surgeries and treatments -- to women having annual mammograms after age 40 outweighed the benefits and resulted in a negligible number of lives being saved. It recommended mammograms every other year for women ages 50 to 74. And it recommended that doctors quit instructing women how to do self exams because the exams proved largely ineffective.
Republican critics of health-care reform immediately seized on the recommendations as another step toward rationing of health care by government bureaucrats and as a backdoor way of saving some of the $3.3 billion spent annually on mammograms.
Said Rep. Marsha Blackburn, R-Tenn., "This is the little toe in the edge of the water. This is where you start getting a bureaucrat between you and your physician. This is what we have warned you about."
The Obama administration immediately distanced itself from the findings. Health and Human Services Secretary Kathleen Sebelius stressed that the study neither sets policy nor determines what procedures the government will pay for. She also stressed that the findings are not binding on physicians and insurers, a show of support that must have the distinguished members of the task force wondering why they even bothered.
Unfortunately, the politicizing of dispassionate medical studies may be one byproduct of health-care reform.
The actual recommendations, available on the task force's Web site and published in the medical journal Annals of Internal Medicine, do raise the question of why all the fuss. The panel made clear exceptions for women with a family history of breast cancer or a genetic predisposition to the disease, and ultimately left the advisability of annual mammograms up to the woman and her doctor, as it should be.
(Distributed by Scripps Howard News Service, http://www.scrippsnews.com)
Mammography is the process of
Mammography is the process of using low-dose amplitude-X-rays (usually around 0.7 mSv) to examine the human breast and is used as a diagnostic as well as a screening tool. The goal of mammography is the early detection of breast cancer, typically through detection of characteristic masses and/or microcalcifications. Mammography is believed to reduce mortality from breast cancer. No other imaging technique has been shown to reduce risk, but breast self-examination (BSE) and physician examination are considered essential parts of regular breast care.
In many countries routine mammography of older women is encouraged as a screening method to diagnose early breast cancer. The United States Preventive Services Task Force recommends screening mammography, with or without clinical breast examination, every 1–2 years for women aged 50 and older. Altogether clinical trials have found a relative reduction in breast cancer mortality of 20%, but the two highest-quality trials found no reduction in mortality. Mammograms have been controversial since 2000, cissp training, when a paper highlighting the results of the two highest-quality studies was published
Like all x-rays, mammograms use doses of ionizing radiation to create images. Radiologists then analyze the image for any abnormal findings. It is normal to use longer wavelength X-rays (typically Mo-K) than those used for radiography of bones.
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