Criticizing cancer screening advocates can be a difficult thing to do.
Gary Schwtizer writes about the case of Rep. Debbie Wasserman Schultz (D-Fla.), who is introducing a new bill advocating breast cancer screening to begin earlier than the current suggested age of 40.
Ms. Wasserman Schultz was diagnosed with breast cancer at age 42, and wants “to educate the public, particularly young women and their doctors, about the need for a much earlier approach to breast cancer detection.”
Now, she is to be applauded for being a breast cancer survivor, and no doubt, has gone through a difficult ordeal, including a double mastectomy and removal of her ovaries.
But, as Mr. Schwitzer notes, it is difficult to criticize health advocates like these without sounding heartless. The fact is, there is no definitive data that mammograms improve the mortality rate, and by pushing for breast cancer screening at an earlier age, millions of young women will be exposed to needless breast biopsies and procedures for the false positives that mammograms invariably find.
The concept of false positives simply doesn’t tug on the emotional heartstrings, which is why those who preach evidence-based medicine will have such a hard time convincing the public that less cancer screening is sometimes better medicine.
Related posts:
- Dangers of false positive mammograms
- "The great majority of women in the United States should not be getting MRI scans for breast cancer screening"
- Lung cancer CT screening produces false positives and isn’t ready for prime time
- Which cancer screening tests are really necessary?
- A 10-year old girl with breast cancer, how much media coverage should she receive?
- Prostate cancer screening in men over 75
- 15 cancer screening posts you may have missed
{ 5 comments }
This is why government is dangerous. It’s a bunch of people who introduce bills and laws for their own self interest masked as for the interest of all.
That’s why we are in the economic mess we are today. Lawyers writing bills for money based on how much money more lawyers give them to vote for the interest of their clients.
What’s wrong with being heartless? Medicine and Public Health are very different beasts. As a physician I strive for empathy with my patients, but as a public health practitioner I need to be as dispassionate and, yes, heartless, about the evidence as I can be; the public’s health depends upon it.
What the public health establishment needs is someone of impeccable character to stand up and say ‘no’ to this tug-at-the-heartstrings nonsense. Either by pointing to the evidence and saying if we do it your way, for every one person like you, we will terrify X women form your age group and perform Y procedures and Z women will have needless therapy. If you want to fight people who use emotional blackmail, you need to fight fire with fire. I’m sure the Congresswoman is a sympathetic character, but stack her against photos of thousands upon thousands of women who would be harmed by mammography in the 40s and you have something to fight back with.
Is it no longer recommended for a woman to get a baseline mammogram at 35?
I have decided to opt out of mammograms in my 40’s. For me the risk of unnecessary harm outweighs the risk that I will be the one who dies of cancer.
The doctors I have seen treat me like I am stupid for making this decision. They use emotional blackmail so I will comply. If there is emotional attachment to mammograms, the medical establishment continues to feed that attachment.
This bill reminds me of the people who think every woman should have an annual CA125 test to detect ovarian cancer. They focus on the possibility that a few lives might be saved while completely ignoring the large numbers of women who would be subjected to unnecessary CT scans and exploratory surgery because of false positives, as well as the women whose false negatives could lead to delayed diagnoses while the cancer progresses.
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