Once again, a detailed look at cancer screening – this time breast cancer. Despite the recent ACP recommendations, it may just come down to this:
In addition, the elephant in the room that no one wants to acknowledge is the medical-legal climate. One of the most common causes of lawsuits, if not the most common, is failure to diagnose breast cancer. What primary care doctor has the cojones not to screen women from 40-49, when the majority of radiology and medical organizations still recommend mammography every 1-2 years between ages 40 and 50, even if the evidence upon which they base these recommendations is not as compelling as that for women over 50?Not me if I were doing primary care. And not me doing breast surgery. Besides, I think that even the more modest benefit of screening women from 40-50 years old is probably worth it.
Related posts:
- "The great majority of women in the United States should not be getting MRI scans for breast cancer screening"
- Why health reformers should be worried about the breast cancer screening backlash
- Will patients accept the new, evidence-based, breast cancer screening guidelines?
- Are we finding too much breast cancer?
- MRI for breast cancer screening
- Is clinical breast examination, added to mammography, worthwhile?
- False positive cancer screening tests doesn’t resonate in Congress
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{ 1 comment }
If the elephant in the room is the medical-legal climate in which we live, isn’t that a good thing. Apparently you acknowledge that there are many physicians with smaller cojones who, without the current medical-legal climate, would forgo offering screening for women < 50. And you also admit, for the benefit confired, "it is probably worth it.
Perhaps it would be ideal if medical decision makers were driven by human factors rather than consequences, but that regretably is not the case. Screening recommendations by policy makers balance benefit and risk well but have a more difficult time balancing benefit – risk vs cost. What is the value of a woman surviving rather than dying prematurely from breast cancer? What is the cost of screening the x number of women in order to save one life?
When the american cancer society and most other medical organizations have gone through the gut wrenching process of making such difficult choices, surely whether the recommended policies should be followed, ought not depend upon the size of one cohones.
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