The politics of cancer screening make entrenched beliefs hard to change

With the recent changes in breast cancer screening, mammograms have increasingly used as a political tool.

Internist Robert Centor points to an article from Politco, which shows how far it’s gone. Not surprisingly, polls have shown that 76 percent of women disagree with the new USPSTF guidelines. And politicians are using this to their advantage. Any suggestion to rein in tests, gets re-framed as, in the case of mammograms, “women’s care under seige.”

And it works, as seen in the recent New Jersey governor’s race, where “Gov. Jon Corzine launched a full-bore TV assault accusing GOP rival Chris Christie of backing a health care policy that would not guarantee mammography coverage for women – a move that, at least temporarily, put the Republican on the defensive.”

Health reformers, who support medical decisions based on data, should be discouraged at how politicized health care has become. When it comes to cancer screening, Dr. Centor puts it best: “Trying to explain the risks and benefits of testing requires more complex thinking. Obviously our political parties are not capable of complex thinking.”


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  • BladeDoc

    The more government in medical care, the more politics. It will get worse.

  • ken covinsky

    It is really too bad the USPSTF didn’t spark a more useful public discussion of the risks and benefits of cancer screening. The media seemed to play right into the inflammatory rhetoric and lost an opportunity to help the public better understand what cancer screening can and can’t do. One thing that gets lost in all this is that the USPSTF did not actually say women age 40-49 should not get mammograms. They did say the balance of risks and benefits did not justify a recommendation for universal screening and advocated for informed individualized decision making.

    In a post on GeriPal, Dr. Sei Lee points out that the public tends to greatly overestimate the benefits of screening and greatly underestimate the risks—to the point that some patients who suffered harms from screening, and did not benefit at all, may actually believe they were helped by screening.

  • Michael Kirsch, M.D.

    Mammogate showed that comparative effectiveness research and implementation will be a much steeper climb than we imagined. A vertical climb, perhaps?

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