On Mammograms
by: Eli Zaretsky on November 19th, 2009 | 6 Comments »
The current debate over the age at which women should begin taking mammograms is a good example of the kind of pseudoscience that may be introduced once costs becomes a guiding consideration in health care decisions.
As I have argued previously, health care is the one thing we should not economize about. Of course, there may be health care necessities that we cannot afford, in which case we should try to figure out how to afford them, for example, through taxation. But the first thing we should do is to be clear as to what the desirable health care options are.
Most current versions of the health care plan avoid all the real ways to preserve best procedures while lowering costs. These include eliminating fee-for-service and putting doctors on salaries, controlling insurance company and hospital profits, getting strict with drug companies, etc., or having a truly vigorous public option — all of these would be politically unpalatable to our glass-jawed president.
Instead, most current proposals pretend to lower costs by introducing best procedures that are supposedly determined scientifically. The current recommendation of the U.S. Preventive Services Task Force to raise the age at which women begin receiving mammograms from forty to fifty is an example of the kind of thing we may expect. (The recommendation explicitly excludes women who have special risk factors.)
The “scientific” reason given by the Task Force for raising the age at which mammograms begin is to avoid “over-treatment,” including the anxiety associated with the tests, the possible risk of false positives, or the discovery of cancers that grow so slowly that they pose no risk.
Now I ask you: how stupid do these experts think American women are? Do they really think that the way to avoid anxiety is to NOT take a test? Do they really think that false positives cannot be discussed with doctors? Do they seriously claim that “anxiety” is a measurable, scientific fact that they can weigh in making their recommendations? How, in other words, are we to evaluate these recommendations when it is impossible not to suspect that the Task Force’s real motivation was to cut costs?
There may be good reasons to change the age at which mammograms begin. The normal age in other developed countries is fifty, not forty. The best procedure should be discussed in the press, in the scientific community and between individuals and their doctors. This is in fact happening as the American Cancer Society and the American College of Radiology have both rejected the recommendation and both advise annual mammograms beginning at age forty. My only point is that the introduction of the issue of costs into this discussion can only contribute to confusion, obfuscation, and the real false positives of supposedly scientific recommendations that are based on economic — i.e., non-medical — considerations.
This is very earily reminiscent of the high-cholesterol scandal with statins (Lipitor). Lancet had a whole hoohah about them and the BMS propaganda campaign to get everyone on them in spite of the science that found correlation but NO causation.
Similar to cost-cutting, once money is the bottom line, things seem to have a history of going badly awry. Science works, money is just a pollutant all too often.
We overuse all kinds of screening and procedures. We also allow infertility treatment, which is absurdly expensive, while bi-racial and black kids languish in foster care all over the nation, for reasons of ideology, bigotry, and poor public policy.
I am far more worried about plutocratic cdouble income wealthy families piling up the money, while delaying their options to concieve until they run out, and then expect the taxpayers to bail them out instead of paying for their own grossly expensive fertilization techniques.
we are lucky that we ahve honest folks in tehmeidcal field explaining their reasoning, and this whole conversation about mammograms began several years ago; to blame this on health care rationing is absurd.
i agree with you Eli about the stupid and vacuous political slant to research…and its predictable outcomes.
But i wonder how are we going to be able to afford to bankroll the unreasonable and exploitive, while we shipwreck the necessary, like reproductive CHOICE.
coathanger anyone?
It is amazing to me that the fact that the risk of getting breast cancer canbe shrplyreduced by dietsry changes is so seldomly addressed.
Much is already known about the causes of breast cancer (and other degenerative diseases), and thus how to significantly reduce the risk. Most breast cancers are found in countries, such as the United States, Great Britain, Australia, Argentina, and Canada, where people eat large amounts of animal fat. An American woman who eats meat daily instead of less than once a week, increases her risk of breast cancer by a factor of 3.8. In countries where little animal fat, especially beef, is consumed, breast cancer rates are significantly lower. For example, in Japan, where fat consumption is far lower than it is in the United States, their breast cancer rate is only one-fourth that of ours. Genetics don’t seem to be the reason; when Japanese women move to the United States and adapt typical American diets, their breast cancer rates rise sharply and approach that of American women.
The Surgeon Generals’ Report on Nutrition and Health (1988)
noted, “A comparison of populations indicates that death rates for
cancers of the breast, colon, and prostate are directly proportional to
estimated dietary fat intakes. After analyzing epidemiological, migration, wartime, and other studies, Robert Kradjian, M. D., a cancer surgeon for 30 years, concluded that animal-based diets are the prime cause of breast cancer.
Hence, a shift to a well-balanced plant-based diet can dramatically reduce the risks associated with breast cancer and other degenerative diseases. It would also have very positive effects for animals, our natural resources, our ecosystems, our climate, and the world’s hungry people.
There are many people who are pushing vegetarianism as healthy. You are all entitlesd to your beliefs, and i am sure most of us can find a scientist to support our views. However, that is only ture insofar as the study doesn’t attack sared cows like the cosmetics industry.
For many eyars there ahs been a group of researchers who ahs tried to bring to teh attention of the most over conmeticized vain nations in the world, the knowledge that anti-perspirants are toxic for women and can cause breast cancer. The Japanese increase in cancer can be also and much more strongly correlated with adopting the western style of utilizing chemical anti-perspirants .
In fact cancer is on the rise in every country that ahs problems with pollution of water, sucha s our own, and a toxic environment.
whilemwe focus on trying to prevent our sweat glands from doing their necessary work to maintain our body’s health, because we might be a little smelly, we have unleashed an epidemic of breast cancer that is like most cancers very sensitive to chemical toxins.
Ther have been recent studies to show that the best diet in the world is the mediterranean diet, where the type of fat consumed is in the main olive oil. Also, some animal fats are health for women, such as milk fat when it comes from a pasteurized milk that ahs not been homoginized. homoginization of milk is widespread, popular, and very unhealthy.
Finally, some recent, sound by unpopular and quickly squelched studies have shown that consuming fat and being slighty above the baseline “norm” for women is healthier and contributes to longevity.
it would be so nice if we would focus on the real true malevolent ills of society instead of srmonizing about body fat uina society of impossible pressure for little girls, including being perfect looking as a requisite to success.
No matter how you sugar coat the Obama health care policies, they amount to killing people. In this case, thousands of women who are not able to get mammograms in their 40s will die of breast cancer.
If you look at the statements of Obama’s advisors–Orzag, de Parle, Ezekiel Emanuel–you see that the intent is to kill people by denying care, in the name of cutting costs. That’s why LaRouche put the Hitler mustache on Obama, because the policies of defining some people–the old and the sick–as not worthy of life in the name of budget cutting, is exactly what Hitler laid out in September 2009.
For more on this, see:
http://www.larouchepac.com/lpactv?nid=12524
Mammograms pose risks to women’s health. Irradiating human tissue can itself cause cancer. I agree with the writer above, over testing is not health “care” it is big business. The attitude toward the body that the mammography industry promotes is one of surveillance of an deadly enemy. I choose not to adopt that attitude toward the miraculous body that carries me through my life. I cultivate the practice of listening to it’s needs for healthy food, exercise and relaxation and say prayers of gratitude each morning and night for the mystery and miracle that my bodily existence represents. My mother died of cancer and I began having screening mammograms at a young age entirely due to my anxiety. It never felt right. After swearing off this awful test some years ago I finally found an alternative. Thermography, a heat-sensitive photograph of the breast, is a safer (and more economical) way to follow breast changes without the pain and risk of mammograms. I suspect this tool will come back into the conversation as women seek out ways to ensure their health without being political footballs.