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New mammogram advice from gov't: Wait another 10 years - Page 3

post #61 of 78
11/18/09 at 4:09pm
Quote:
Originally Posted by 2dogmom View Post
I already posted it but fine I'll post it again.
From the American Cancer Society, see Figs 3 and 5:
http://www.cancer.org/downloads/STT/...%209-08-09.pdf
The trend in incidence rates is that they have been going up since about 1980. They peaked in 1999-2000 but even with the decrease since then they are still higher than decades before.

Ultrasounds are not only more accurate, they do no harm. The accuracy of the mammogram is so bad you might as well flip a coin. I do agree with you that the needle biopsy is the only 100 % reliable way to go. If I thought I felt something from a self exam I'd go for a biopsy and bypass the mammogram myself. But each to her own.
I know my view is not popular but I also believe the ultrasound is better than a mammogram.
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post #62 of 78
11/18/09 at 5:11pm
Quote:
Originally Posted by Yosemite View Post
I know my view is not popular but I also believe the ultrasound is better than a mammogram.
No doubt about it Linda, Ultrasounds ARE better.
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post #63 of 78
11/18/09 at 6:12pm
Again, it was the big subject on NPR today.

Diane Rehm (if you go there after today, check the archive):

http://wamu.org/programs/dr/

Talk of the Nation:

Talk of the Nation

On Point:

On Point

Very interesting discussions. And some very important facts. Such as, 25% of all breast cancers occur in women from 40-49.
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post #64 of 78
11/19/09 at 5:06am
Here is another article:
Quote:
The expert panel -- which recommended that women in their 40s should no longer get annual mammograms to screen for breast cancer -- sparked an outcry from those who say that the federal government is more interested in saving money than in improving women's health, even though the panel did not consider costs in its analysis.
...
"Unfortunately, there is no magic way to make these decisions," said Dr. Sean Tunis, a former chief medical officer for Medicare and Medicaid in the George W. Bush administration who works on ways to evaluate medical technology.

The problem, Tunis and others experts say, is that leaving the decisions to the marketplace -- as the U.S. healthcare system has done for decades -- has not produced very good results, even for patients.

Doctors in one hospital may favor one surgical procedure or drug regimen, while those in another favor something else. Individual insurance companies decide to cover some procedures and not others, often varying their policies from patient to patient.

Even state lawmakers have gotten in on the act, passing hundreds of laws requiring that insurance companies provide particular benefits such as prostate cancer screening or, in one case, varicose vein treatment. According to the Council for Affordable Health Insurance, an industry group, there are more than 2,000 insurance mandates nationwide.

The variations and the resulting differences in the way that patients are cared for is one of the main reasons that the American healthcare system is so inefficient, many experts think.

The United States spends a greater share of its gross domestic product on healthcare than any other industrialized country, yet ranks near the bottom in many outcome measures such as unnecessary deaths and infant mortality.
http://www.latimes.com/features/heal...,3113676.story
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post #65 of 78
11/19/09 at 4:26pm
Quote:
Originally Posted by 2dogmom View Post
One thing I have read is that the "infant mortality" rate comparison is baloney. We rank lower because we use a different criteria for measurement than other countries do.

http://www.ewtn.com/library/PROLENC/ENCYC056.HTM

Quote:
The American Medical Association notes that, in the United States, premature babies with extremely low birthweights who have no chance at all of surviving are classified as "live births." Generally, a baby born after twenty weeks' gestation is counted in this category. In other developed countries, such babies are classified as "late fetal deaths."[2]

This disparity in accounting procedures alone, if corrected, would make the infant mortality rate of the United States comparable to that of Sweden or Japan.
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post #66 of 78
11/19/09 at 4:33pm
Quote:
Originally Posted by 2dogmom View Post
This is a great article...
It shows another way through which money is spent unnecessarily while more business is created -but it leads to negative side effects for people..
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post #67 of 78
11/19/09 at 6:51pm
Quote:
Originally Posted by ut0pia View Post
This is a great article...
It shows another way through which money is spent unnecessarily while more business is created -but it leads to negative side effects for people..
I don't understand what do you mean, "It shows another way through which money is spent unnecessarily."

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post #68 of 78
11/19/09 at 7:07pm
I actually set up an appt for a mammogram for myself.I just turned 40,and have ALOT of breast cancer in BOTH sides of the family.
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post #69 of 78
11/19/09 at 7:08pm
I mean, in the US sometimes we do unnecessary things just to create more business...Like with the recommendation to get vaccines yearly for cats while research shows it may not be necessary to do them yearly but rather every three years, and not only unnecessary but may also be harmful to the cats..

Now this may not be the case, I really have no idea about mammograms, but it seems a valid point.
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post #70 of 78
11/21/09 at 1:12pm
Here's an interesting piece on the history of the mammography debate written by an internist cum professor of history and sociology of science:
Addicted to Mammograms
Quote:
THE United States Preventive Services Task Force’s recommendation this week that women begin regular breast cancer screening at age 50 rather than 40 is really nothing new. It’s almost identical to the position the group held in the 1990s.

Nor is the controversy that has flared since the announcement something new. It’s the same debate that’s gone on in medicine since 1971, when the very first large-scale, randomized trial of screening mammography found that it saved the lives only of women aged 50 or older. Despite the evidence, doctors continued to screen women in their 40s.

Again in 1977, after an official of the National Cancer Institute voiced concern that women in their 40s were getting too much radiation from unnecessary screening, the National Institutes of Health held a consensus conference on mammography, which concluded that most women should wait until they’re 50 to have regular screenings.
Quote:
During the 1930s and ’40s, more and more cancer was being diagnosed. The rising numbers led to even greater pressure to define early stages of cancer and find more cases as early as possible. Meanwhile, the apparent improved cancer survival rates — a result of more people receiving diagnoses, many for cancers that were not lethal — seemed to prove the effectiveness of the “do not delay” campaign, as well as radical cancer surgery.

By the 1950s, some skeptics were pointing out that despite all the apparent progress, mortality rates for breast cancer had hardly budged. And they continued not to budge; from 1950 to 1990, there were about 28 breast cancer deaths per 100,000 people. But calls for earlier diagnosis only increased, especially after screening mammography was introduced in the 1960s.
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post #71 of 78
11/24/09 at 7:34pm
Thread Starter 
Quote:
Originally Posted by jcat View Post
Here's an interesting piece on the history of the mammography debate written by an internist cum professor of history and sociology of science:
Addicted to Mammograms
From the same article:

Quote:
They generally sidestep the question of whether the very small numbers of lives potentially saved by screening younger women outweigh the health, psychological and financial costs of overdiagnosis.
Silly me, but I figure that the one life that is saved is worth a helluva lot more than any financial costs you can quote.

It also occurred to me that the countries where the screening is along these same guidelines, i.e. Canada, Britain, Germany & other European countries, all have healthcare paid for by the government. Note that the US government made this recommendation as well. Does anyone else find this coincidence a little hard to swallow?
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post #72 of 78
11/24/09 at 7:39pm
Quote:
Originally Posted by valanhb View Post
It also occurred to me that the countries where the screening is along these same guidelines, i.e. Canada, Britain, Germany & other European countries, all have healthcare paid for by the government. Note that the US government made this recommendation as well. Does anyone else find this coincidence a little hard to swallow?
How many examples of western, developed countries can you think of that don't have healthcare paid by the government, besides the US? And how many of them recommend mammograms for women over 40, once per year? There aren't many, and that tells me that the parallel that you pointed out is circumstantial.
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post #73 of 78
11/24/09 at 7:45pm
Ut0pia, since when does the Government pay for anything? Where, exactly, does the government get money?
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post #74 of 78
11/24/09 at 11:34pm
Quote:
Originally Posted by ckblv View Post
Ut0pia, since when does the Government pay for anything? Where, exactly, does the government get money?
It gets the money from its citizens...but it pays for stuff in the sense that it's the one that writes the checks.
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post #75 of 78
11/25/09 at 5:17am
Quote:
Originally Posted by valanhb View Post
Silly me, but I figure that the one life that is saved is worth a helluva lot more than any financial costs you can quote.

It also occurred to me that the countries where the screening is along these same guidelines, i.e. Canada, Britain, Germany & other European countries, all have healthcare paid for by the government. Note that the US government made this recommendation as well. Does anyone else find this coincidence a little hard to swallow?
I agree about financial costs but not about health costs. Is it worth saving one life to ruin several others? A hard ethical question I know but I think one that had to be looked at.

And when I lived in Germany which admittedly was a few years back, healthcare was NOT paid for by the government! I paid about 15% of my gross salary for health insurance. I had no choice in the matter but then again neither did anyone else.
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post #76 of 78
11/25/09 at 10:29am
Quote:
Originally Posted by 2dogmom View Post
I agree about financial costs but not about health costs. Is it worth saving one life to ruin several others? A hard ethical question I know but I think one that had to be looked at.

And when I lived in Germany which admittedly was a few years back, healthcare was NOT paid for by the government! I paid about 15% of my gross salary for health insurance. I had no choice in the matter but then again neither did anyone else.
That's still the case - we currently pay 15.5%.
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post #77 of 78
11/25/09 at 11:26am
Thread Starter 
Quote:
Originally Posted by 2dogmom View Post
I agree about financial costs but not about health costs. Is it worth saving one life to ruin several others? A hard ethical question I know but I think one that had to be looked at.

And when I lived in Germany which admittedly was a few years back, healthcare was NOT paid for by the government! I paid about 15% of my gross salary for health insurance. I had no choice in the matter but then again neither did anyone else.
My apologies in not completely understanding the insurance situation there. However, since it is a mandatory percentage that sure sounds like a tax to me. And I presume that it is a single, government run insurance plan? If I'm wrong, please let me know.

I have to disagree that a false positive with the mammogram that is proven false with a needle biopsy has ruined anyone's life. I've known a couple people that happened to. Made for a few tense weeks, but it certainly didn't last longer than that. They didn't go into cardiac arrest or get stress ulcers because of it. (If they would have, they had other issues besides a mass bring detected!)

I still fail to see where any number of false positives, or actual positives for masses just false positives for cancer, has the same impact that death has for the person whose cancer was detected early. Besides the stress of going through more testing, can anyone give me actual reasons why a false positive is so detrimental to anyone except insurance companies who have to pay for the additional tests?
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post #78 of 78
11/25/09 at 11:42am
Quote:
Originally Posted by valanhb View Post
My apologies in not completely understanding the insurance situation there. However, since it is a mandatory percentage that sure sounds like a tax to me. And I presume that it is a single, government run insurance plan? If I'm wrong, please let me know.
No, it's not a single government-run plan. There are currently around 200 compulsory health insurance funds (of varying types, like regional medical insurance plans, company health insurance funds, trade/guild sickness funds) where premiums are based on gross income, plus private health insurance funds, where premiums are generally based on age.
This article gives a brief explanation of the current system:
Health Reform Without a Public Plan: The German Model

Quote:
In Germany, statutory health insurance, which covers 90 percent of the population, is financed by a payroll tax. The individual’s premium is not a per-capita levy, as it is in the United States. It is purely income-based. Ostensibly, about 45 percent of the premium is contributed by employers, although economists are persuaded that ultimately all of it comes out of the employee’s take-home pay (See this and this).
An employee’s non-working spouse is automatically covered by the employee’s premium.
Unemployment insurance pays the premiums for unemployed individuals, and pension funds share with the elderly in financing their premiums, which are set below actuarial costs for the elderly.
Finally, premiums for children are covered by government out of general revenues, on the theory that children are not the human analogue of pets whose health care should be their owners’ (parents’) fiscal responsibility. Instead, children are viewed as national treasures whose health care should be the entire nation’s fiscal responsibility.
The health insurance premiums paid by Germans are collected in a national, government-run central fund that effectively performs the risk-pooling function for the entire system. This fund redistributes the collected premiums to some 200 independent, nongovernmental, competing, nonprofit “sickness funds†among which Germans can choose.
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