I just moved my mini-pharmacy from the kitchen back to the medicine cabinet in the bathroom. I hope I didn’t jinx anything.
Women should now get mammograms starting at age 50, not 40.
Who says?
The U.S. Preventive Services Task Force. It recently published its recommendations in the Nov. 17, 2009, issue of the Annals of Internal Medicine, published 24 times a year by the American College of Physicians.
Who is the U.S. Preventive Services Task Force?
It’s a panel of 16 people from the medical community and 14 “evidence-based practice centers,” which includes medical-research universities and institutions and — at the top of the list — Blue Cross Blue Shield.
(Blue Cross Blue Shield started a site called Get Health Reform Right earlier this year to express the insurance industry’s wishes regarding health-care reform, such as, “Creating a new government plan would cause the employer-provided health insurance system that 160 million Americans rely on today to unravel.”)
U.S. Secretary of Health and Human Services Kathleen Sebelius released a statement Nov. 18, saying, “I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action.” Anyone who says the task force doesn’t influence what private insurance companies do regarding mammograms needs to read the task force’s Web site, which explains that one of its goals is to inform and develop coverage decisions.
The EPCs review all relevant scientific literature on clinical, behavioral, and organization and financing topics to produce evidence reports and technology assessments. These reports are used for informing and developing coverage decisions, quality measures, educational materials and tools, guidelines, and research agendas. The EPCs also conduct research on methodology of systematic reviews. [Emphasis added is mine.]
Besides, where do they think the current mammogram guidelines come from?
To come up with this most recent recommendation, the task force looked at research done in China and Russia.
The research in China (“Randomized Trial of Breast Self-Examination in Shanghai: Final Results,” published Oct. 2, 2002, in the Journal of the National Cancer Institute, Oxford University Press) found that “the efficacy of breast self-examination for decreasing breast cancer mortality is unproven,” based on 266 breast-cancer deaths (135 in the main group and 131 in the control group) over 10 years. The study was conducted from October 1989 to October 1991, and women were followed through December 2000. The task force apparently took the difference of only four breast-cancer deaths to show that breast self-examination plays no part in saving women’s lives from breast cancer.
However, the authors of that study also said, “This was a trial of the teaching of BSE, not the practice of BSE.” They went on to say:
It should not be inferred from the results of this study that there would be no reduction in risk of dying from breast cancer if women practiced BSE competently and frequently. It is possible that highly motivated women could be taught to detect cancers that develop between regular screenings, and that the diligent practice of BSE would enhance the benefit of a screening program.
Yet, the task force recommends that physicians stop teaching patients how to do breast self-examinations.
The articles about the research in Russia are all published in Russian. Unless someone on the task force can read and understand Russian, or unless the task force had the articles translated, it’s fair to say that nobody on the task force read anything other than abstracts on Medline, which provide incredibly limited information, except for dates of publication.
Others weigh in
I really don’t know. But David Goldhill has some smart things to say in “How American Health Care Killed My Father” in the September 2009 issue of The Atlantic.
Watch out, Viva Viagra boys. Seems your little blue pills might be “chipped” with RFID (Radio Frequency Identification).
Pharmaceutical companies and hospitals are now beginning to add to the first wave of RFID adoption, at least in the case of high-value drugs such as Viagra.
Guess maybe it’s not always true, “What happens in Viagra, stays in Viagra.” Eh?
