In an article in Nature Reviews, Clinical Oncology Vincent DeVita writes a compelling editorial in essence damning the recommendations of the past year, not because they were wrong, which in a sense they were, but because there was inadequate evidence to say one way or the other. This editorial should become widespread because it shows the impact of non evidence based medicine. It shows what a Government can do when those who opine on what should be done do so with little or worse with no evidence.
DeVita states:
The epitome of this silliness is illustrated over the recommendations for breast self examination or breast examination by a physician. There has never been and never will be any data to prove it works to reduce overall mortality from breast cancer for the reason cited above. nonetheless, women do on occasion pick up early lesions that might save their lives so why shouldn’t they examine their breasts in an organized way.
It costs nothing. what is more, if physicians follow the USPSTF recommendation they should not include an exam of the breasts in a routine physical exam either. How silly is that? First, patients and doctors alike will pick up early lesions that might, at a minimum, alter the nature of treatment in the patient’s favor. second, a physical exam is a physical exam and a good physician will examine the entire body.
Gail Collins a columnist at the Washington Post, who wrote about the USPSTF controversy quipped, appropriately enough, that if we follow the USPSTF recommendations “a woman’s breasts should never be touched except in anticipation of sex”.
I think she captured the silliness of their recommendation in that phrase. we simply cannot be sure that altering the current screening recommendations for breast cancer will benefit anyone. it then simply becomes an issue, no matter who may say it isn’t, of who pays for it. and that’s a separate debate. But, in my view, a woman who wants the security of screening by mammography should not be denied it.
DeVita is spot on. Yet the real conclusion is that despite the fact that DeVita says this and he is the author of the most prominent book on Cancer today, those on the panel apparently did not include a single practicing oncologist! At least there were a few physicians, not that they could communicate based upon what I could see at the time. But imaging under the proposed health care plans what would happen is the decision make were to be a GS 13 in Washington with an attitude! Imagine if as the law infers, not implies, infers, that a physician could be punishable by recommending a procedure deemed unworthy by the GS 13, whoever that person would be. That has and will remain my key obstacle which is created by the current health plans.
DeVita states:
The epitome of this silliness is illustrated over the recommendations for breast self examination or breast examination by a physician. There has never been and never will be any data to prove it works to reduce overall mortality from breast cancer for the reason cited above. nonetheless, women do on occasion pick up early lesions that might save their lives so why shouldn’t they examine their breasts in an organized way.
It costs nothing. what is more, if physicians follow the USPSTF recommendation they should not include an exam of the breasts in a routine physical exam either. How silly is that? First, patients and doctors alike will pick up early lesions that might, at a minimum, alter the nature of treatment in the patient’s favor. second, a physical exam is a physical exam and a good physician will examine the entire body.
Gail Collins a columnist at the Washington Post, who wrote about the USPSTF controversy quipped, appropriately enough, that if we follow the USPSTF recommendations “a woman’s breasts should never be touched except in anticipation of sex”.
I think she captured the silliness of their recommendation in that phrase. we simply cannot be sure that altering the current screening recommendations for breast cancer will benefit anyone. it then simply becomes an issue, no matter who may say it isn’t, of who pays for it. and that’s a separate debate. But, in my view, a woman who wants the security of screening by mammography should not be denied it.
DeVita is spot on. Yet the real conclusion is that despite the fact that DeVita says this and he is the author of the most prominent book on Cancer today, those on the panel apparently did not include a single practicing oncologist! At least there were a few physicians, not that they could communicate based upon what I could see at the time. But imaging under the proposed health care plans what would happen is the decision make were to be a GS 13 in Washington with an attitude! Imagine if as the law infers, not implies, infers, that a physician could be punishable by recommending a procedure deemed unworthy by the GS 13, whoever that person would be. That has and will remain my key obstacle which is created by the current health plans.
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