For all the disagreement and debate over health care lately, it ought to be satisfying that many Americans can still find some common ground on which to unite. Unfortunately being united in confusion isn't necessarily a good thing. Such was the case earlier this week when a federal panel, the Preventive Services Task Force, issued a new set of recommendations for women on the type of screening they ought to undergo to test for breast cancer.
For all the disagreement and debate over health care lately, it ought to be satisfying that many Americans can still find some common ground on which to unite. Unfortunately being united in confusion isn't necessarily a good thing.
Such was the case earlier this week when a federal panel, the Preventive Services Task Force, issued a new set of recommendations for women on the type of screening they ought to undergo to test for breast cancer. The independent board concluded that women in their 40s without elevated genetic or environmental risk for the disease get little help, statistically, from annual mammograms, and that those over age 50 likely benefit from one only every two years. It also said there is little value to women learning to conduct regular self-exams.
The advice is hotly contested by medical and advocacy groups that include the American Cancer Society and Susan G. Komen for the Cure. These and other prominent organizations call for women and doctors to stick to a schedule of care involving annual mammograms beginning at age 40, and recommend that all women should perform self-exams as they are best to discern what simply doesn't feel right.
"My phone has been ringing off the hook," says Linda Washkuhn, who has been involved with the Komen foundation since its inception and brought the annual Race for the Cure to Komen's native Peoria a quarter-century ago. Underneath the shock and concern many women felt has been this doubt: Whose advice is right?
As ever, patient and doctor have a role here far greater than nonbinding advice from a government panel. That's a message the feds have scrambled to get out there in the last day or so to quiet the controversy. Health Secretary Kathleen Sebelius was blunt, telling women, "Keep doing what you have been doing for years: Talk to your doctor about your individual history, ask questions and make the decision that is right for you." Naturally that begs the questions: What use was the panel's work? What did we fund them for?
As with most government reports, this one is impersonal, laden with dry facts and figures. We have no doubt the studies used are scientifically valid and difficult to knock down. Indeed, it's easy to see how panel members used page after page of studies to arrive at a conclusion that certain treatments don't always offer overwhelming value. The earlier, repeated screenings carry with them the possibility of more false alarms, more unnecessary biopsies. On a strict reading of numbers only, the incidence of breast cancer among women in their 40s is low, the number of false positives is high, the stress from waiting for tests can be enormous.
But we aren't a society of computers and robots; statistics must give way to the human faces behind them, the women who develop breast cancer before age 50. "Susan G. Komen, who was my best friend, was diagnosed at age 33," Washkuhn reminds people. "Breast cancer can strike any woman at any time. That is a fact." Folks like Komen, who the panel members might dismiss as as "statistical outliers," don't always have any early warning without these tests, and every one of them who has battled breast cancer is justification for the better-safe-than-sorry approach early screening offers.
"You think of a women who is under 50, there is no question she would rather have a false positive and find out there is nothing to worry about than miss it," Washkuhn says.
Still, if there is any bright side to be found from the wave of outcry these past few days, it's that more people are discussing the value of awareness and early detection. This should serve as a reminder to question what we hear, demand answers from our physicians and take an active role, doing everything possible to avoid being caught off guard by a terrible disease.
Peoria Journal Star