Our View: Women’s health should be taken seriously

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Editorial Board, October 2009 through February 2010

  • Suzanne Schlicht, general manager
  • Brent Boyer, editor
  • Blythe Terrell, city editor
  • Tom Ross, reporter
  • Michelle Garner, community representative
  • Paula Cooper Black, community representative

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— When a national task force issued new mammogram recommendations last month, it led to an uproar from people concerned about the impacts on women’s health.

The U.S. Preven­tive Services Task Force has said that women ages 50 to 74 should have breast cancer screenings every two years. The previous standard was that women receive annual breast cancer screenings beginning at age 40 and continuing as long as a woman is in good health.

In an article in Sunday’s Steamboat Pilot & Today, local doctors, including breast cancer survivor Rosanne Iversen, expressed concern and disagreement with that recommendation.

“My own opinion is that women should get routine screenings starting at age 40,” said Iversen, who was diagnosed at age 44.

We aren’t doctors, and we can’t attest to the medical validity of the recommendations. But we do encourage women to take an active role in maintaining and monitoring breast health. Each person is different, and women should continue to do self-exams and communicate with their doctors about breast cancer.

Some critics are worried that the new recommendations will cause insurance companies to change their policies about paying for mammograms, making the technology difficult for women to afford.

We understand that insurance companies paying for fewer mammograms could decrease costs for everyone. But we’re also concerned about the lives of the members of our community who are affected by breast cancer.

We’re concerned about women who need them having access to mammograms, and we’re also bewildered by the task force’s recommendation against teaching self breast exams, saying self-exams aren’t linked to a decrease in breast cancer mortality rates.

According to the National Breast Cancer Foundation, “nearly 70 percent of all breast cancers are found through self-exams, and with early detection, the 5-year survival rate is 98 percent.” The foundation also advises a calm response for those who find a lump. They should schedule a doctor appointment but “don’t panic — 8 out of 10 lumps are not cancerous.”

Groups that fight breast cancer have struggled for years to raise awareness about the importance of self-exams and mammograms. We can’t help thinking that these recommendations represent a step backward. With breast cancer, as with other cancers, early detection is crucial. If self-exams, which don’t cost a dime, save even one life, we think that makes them worthwhile.

The American Cancer Society’s chief medical officer, Otis Brawley, issued a statement about the task force’s recommendations.

“The American Cancer Society continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40,” he said.

He goes on to question the value the task force places on a life.

“The (task force) says that screening 1,339 women in their 50s to save one life makes screening worthwhile in that age. Yet (the task force) also says screening 1,904 women ages 40 to 49 in order to save one life is not worthwhile. The American Cancer Society feels that in both cases, the lifesaving benefits of screening outweigh any potential harms.”

According to the society’s Web site, www.cancer.org, an estimated 192,370 new cases of breast cancer have been diagnosed in 2009. An estimated 40,170 people will die from breast cancer this year, according to the figures.

The Web site states that “the chance of a woman having invasive breast cancer some time during her life is a little less (than) 1 in 8. The chance of death from breast cancer is about 1 in 35.”

And, the American Cancer Society notes, “breast cancer death rates have been going down. This is probably the result of finding the cancer earlier and better treatment.”

Yampa Valley Medical Center is working to provide better services to prevent breast cancer, and we applaud that. The hospital has new mammogram technology and performs an average of 2,300 mammograms a year. Doctors detect about 25 breast abnormalities per year.

In our small community, those diagnoses affect a lot of lives. We encourage women to protect their own by continuing to do self-exams and by following their doctors’ advice.

Comments

Scott Wedel 4 years, 11 months ago

Did anyone actually read the study? The study was not some cost cutting effort saying that it is not worth screening women for breast cancer.

The study was also concerned with women's health. The study basically said that self examinations are effective and the medical consequences of finding tiny lumps in women with no risk factors is often greater than that person's risk of actually having cancer.

Note that 70% of cancers are found by self examination. That is because breast cancers tend to grow quickly and an annual examine has a relatively small window of detecting the growing cancer before the woman detects it. The medical results show no great difference in outcomes if the woman detects it or if detected by the mammogram. There is a raging medical debate over what to do about tiny precancerous cell groupings. Some doctors treat that the same as breast cancer. Others say that is basically normal and wait until there is a lump of a certain size.

The real effect of the study should be for women to ask their doctors and make informed decisions of what is best for their health.

Just as their is a huge difference between how European countries and the US deal with enlarged prostates with precancerous cells. They basically take a wait and see approach while we are far more likely to have surgery. Their approach costs less, but more important, it results in better health. They have a similar cancer death rate, but have far fewer post surgery issues.

No health insurance had proposed cutting coverage for mammograms. It'd be a politically suicidal move and pointless because any patient could always claim she felt a lump.

This "controversy" is not about better health. It is all about the truth offending political dogma.

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Kevin Chapman 4 years, 11 months ago

This is yet another reason for healthcare reform, the insurance business is driving the decisions being made about our health. With all of the money our country dumps into healthcare, whether it be prescription drugs or research and development, our survival rates are not appreciably different than say......Canadian Healthcare.

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