‘No, thanks’ to new cancer guidelines

I’ve been calling around to doctors’ offices for the last two days to talk with them about the new mammography guidelines floated this week by the U.S. Preventive Services Task Force. The task force recommended that most women 40 to 49 no longer receive routine mammograms to screen for breast cancer. The panel recommended that these screenings begin at age 50 for most women.

What’s surprised me while making these calls is the unanimity of opinion that I’ve heard and the passion. Doctors in the Fredericksburg area, at least the half dozen that I’ve spoken with, don’t like the new guidelines and don’t intend to follow them. I’ve heard words like “frightening,” “infuriating” and “infamous” to describe the proposal. Doctors here have first-hand evidence from their patients that a baseline mammogram at 35 and annual mammograms beginning at 40 can detect cancers early when they’re more treatable.

For more local reaction to the federal proposal, see the story in the paper this weekend.

Permalink: http://news.fredericksburg.com/rapidassessment/2009/11/20/no-thanks-to-new-cancer-guidelines/

derarzt

What is their specialty? Do they base their opinion on large studies published in peer-reviewed medical literature, or their own limited experience, or, more likely, the last case they saw? Do these “local docs” have ANY vested interest in this; they own mammography equipment, interpret the studies, do biopsies? Remember, Geo Washington’s doctors did not commit malpractice when they bled him to death because that was the standard of care in 1799; they were still wrong based on science.
spooncroon

Don’t you suppose that once the full story is in the newspaper it will say who the local docs are, and what their specialties are? I guess it’s an interesting topic, though, and not without controversy.
lulu0202

I’m glad local doctors are taking this stand. Delaying yearly mammograms until 50 is dangerous and playing with women’s lives. Breast cancer has killed 2 women in my family and I will be getting yearly mammograms once I turn 40.
tpifos

It sounds like the feds are starting their cost cutting
healthcare rations early. Probably so they won’t get
blamed like they would if they did it after the govt run
healthcare plan is in place.
rellascout

How many people have read the study? This is an emotional issue but the reality is that the report is fact based. It has not been show to be inaccurate. You can disagree with the findings but it should be done on a scientific not an emotional or anecdotical manner. The facts are that you need to do 19,000 to possibly save one life. These are the facts.
rellascout

Personally I know for a fact many of the Drs. in this area have a vested interest in imagery services. They do not want to see this service diminished. Dr. also do not want this service to be taken out of the annual visit rotation. The assumption that their objection is based solely on health would be false IMHO.
derarzt

in her family would be, by definition, “high risk” & SHOULD NOT wait to 50 years old to start annual mammogram screening. The guidelines should not & would not apply to her. She most certainly should discuss earlier screening with her own personal physician. What she should be most afraid of is being labeled with a “pre-existing condition” (in this case, family propensity toward breast cancer) & on that basis denied health insurance.
tpifos

To say Drs are doing mammograms for the $ is like
saying pediatricians are taking out tonsils for the $. It’s
BS. I don’t know any Dr. who does office
mammograms. Most women who develop breast cancer
have no risk factors & no family history of the disease.
So, rellascout if that 1 in 19,000 woman who dies of
breast cancer was your wife, mother, sister or daughter,
how would you feel if her life could have been saved
with earlier detection?
rellascout

What world are you living in? You obviously know nothing about how medicine is practiced in this country. Do the research and get back to me.

http://www.prattmed.com/locations.html

http://rafimaging.com/

http://www.medicorp.org/imagingservices.mgi
lulu0202

There is such a misdirected hate toward doctors and the big, bad insurance companies. Having 2 relatives die from cancer will label me with a pre-existing condition is a ludicrous claim. I have wonderful health insurance that I work and pay for. If 1 live can be saved by doing 19,000 “unnecessary” mammograms, then those odds are justifiable enough for me.
derarzt

gotta agree!! Some comments suggest lack of acquaintance with the real world of medicine as a business. That being said, my high school buddies & I are pooling our loose change & buying an MRI Total Body Scanner. We’re hoping Mr. Hall & other bloggers here will promote biannual total body scans starting at age 10 to diagnose hidden disease. Our advertisements will point out that any dissension by the government that they are not necessary is obviously an attempt to ration health care!!
rellascout

$80 to $120…. Again you are using anecdotal evidence to prove a statical point? x=1 is not an argument or a proof.

I am not putting a price on a human life but I believe that you are naive if you think healthcare in this country is not a business. I am libertarian and believe in the free market so I do not consider it a bad thing but I am no Obama Kool aid drinker but I know enough to see healthcare as the industry it is and should be.
derarzt

My gawd!! Blue Cross & Blue Shield quotes $102 as the average cost of a screening mammogram. At 19,000 “unnecessary” exams, thats $1,938,000. Now, before everyone jumps all over me, I’m not asking whether that should be spent to save one life, but only, who’s going to pay for it?
tpifos

Of course there are crooks in every business– kinda like
several of the appointees in the Obama Administration &
in Congress. And maybe derarzt since he seems to be in
it for the money. But that’s no excuse to justify fewer
diagnostic tests for cancer.
pennylloyd

In 2005, at the age of 36, my ob/gyn ordered a mammogram for me – no lumps, no family history. Thinking back, I am sure he did this for the kickback from Medicorp, however, he probably saved my life as I was dx / infiltrating ductal carcinoma. The thought of drs recommending the age of 50 for the first screening disgusts me!
aidia

Love the timing of these new findings, and I wonder about their research funding *cough*US Gov*Cough*, no yearly mammograms until 50 then cut off at 70, 2 year rather than 1 year pap smears for ladies in their 20s…welcome to the beginnings of National health care…
tpifos

There was a recent article about the doc who was denied
a CT scan machine because the state regulates who gets
them & how many there are. Same for MRI machines.
Docs don’t get the $$. Blame the state. They limit the
numbers which raises the cost. Medicorp owns all the
MRI machines here, not the docs.
tpifos

It’s illegal. They’re called Stark Laws and they are
nationwide. If you’re a doc you can’t own an MRI
machine & also order MRI tests.
tpifos

Medicorp owns all of them in this area. The state
regulates the numbers. Fewer machines mean higher
costs. Blame the state & Medicorp for that. Docs can’t
own MRI machines & also order tests on those machines.
Violation of Stark Laws. It’s illegal. There was an
article recently about the doc who couldn’t get approval
CAT Scan machine because the state wouldn’t allow it.
derarzt

So that the avg lay person can determine whether bloggers here are prescient wrt the consequences of the recent US Preventive Services Task Force recommendations, would bloggers please indicate their medical school alma maters & years of graduation. Can they identify the members of the Task Force, & their academic credentials (Medical Doctor, Master of Public Health, PhD, epidemiologist, statistician)? Would they mind citing the academic studies upon which the USPSTF bases its recommendations, & point out how & why they feel they are in error? Please restrict yourselves to peer-reviewed journal articles & uniformly well regarded authorities in their fields. Citing National Concensus papers & symposia would also help. It would probably also be useful to know the political affiliations of the Task Force members.

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‘No, thanks’ to new cancer guidelines