AP story focuses on overuse of medical treatments
Lindsey Tanner of The Associated Press addresses the overtesting and overtreatment that have become the focus of several studies and journal articles.
Tanner points to President Obama’s recent medical checkup, during which he had a prostate cancer screening and a virtual colonoscopy - neither of which is normally recommended for patients his age.
Increasingly, experts are questioning whether doctors are practicing “defensive medicine” - ordering tests and treatments to be sure they have covered all the bases even if they are not indicated. Other factors, such as a fee-for-service system and patients who insist on testing and treatments, also come into play.
This week alone, a New England Journal of Medicine study suggested that too many patients are getting angiograms — invasive imaging tests for heart disease — who don’t really need them; and specialists convened by the National Institutes of Health said doctors are too often demanding repeat cesarean deliveries for pregnant women after a first C-section.
Last week, the American Cancer Society cast more doubt on routine PSA tests for prostate cancer. And a few months ago, other groups recommended against routine mammograms for women in their 40s, and for fewer Pap tests looking for cervical cancer.
The focus on overtesting and overtreatment comes the same week CBS News sent out a press release announcing that Early Show anchor Harry Smith underwent a colonoscopy on live television, reported on by Katie Couric. The press release proclaims:
Following Couric’s on-air colonoscopy in 2000, University of Michigan researchers documented a 20% increase in the number of colonoscopies performed across the country, dubbing it “The Couric Effect.”
Prof: Mammogram debate is data vs. anecdotes
When it comes to the recent news that a government task force opposes routine mammograms for women under 50, the public must balance research with anecdotal evidence, according to a professor who studies how breast cancer is portrayed in the media.
Cynthia Ryan, Ph.D., an associate professor of English at the University of Alabama at Birmingham, says the media is doing a “decent” job of covering the debate between the new guidelines from the U.S. Preventive Services Task Force and individuals who are advising that women continue to start having mammograms at age 40.
The professor, who has a book coming out about “the rhetoric of breast cancer in popular women’s magazines,” explains why consumers are torn:
Ryan says that when confronted with extreme representations, there is a part of the human brain that wants to go with scientific study “because we figure it must be credible and rational,” she says. “But another part of our brain embraces anecdotal advice that links the message with a face.
Cancer society’s messages on screening conflict
Filed under: Conflicts of interest, Hot Health Headline, Public health
The New York Times‘ Gina Kolata reports that the American Cancer Society, a longtime defender of early detection and cancer screening, is planning to release an online message next year “to emphasize that screening for breast and prostate cancer and certain other cancers can come with a real risk of overtreating many small cancers while missing cancers that are deadly.”
“We don’t want people to panic,” said Dr. Otis Brawley, chief medical officer of the cancer society. “But I’m admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated.”
The ACS’ change of heart on breast and prostate screening was inspired, in part, by a recent analysis published in JAMA.
In it, researchers report a 40 percent increase in breast cancer diagnoses and a near doubling of early stage cancers, but just a 10 percent decline in cancers that have spread beyond the breast to the lymph nodes or elsewhere in the body. With prostate cancer, the situation is similar, the researchers report.
In an interesting side note, Kolata includes a quote from Colin Begg, a biostatistician at Memorial Sloan-Kettering Cancer Center in New York, that shows a different perspective on media coverage of the screening debate.
“I am concerned that the complex view of a changing landscape will be distilled by the public into yet another ‘screening does not work’ headline,” Begg said. “The fact that population screening is no panacea does not mean that it is useless,” he added.
Kolata’s story was published on Tuesday. On Wednesday, the ACS released a statement from Brawley in which he says the organization stands by its screening recommendations. In the statement, Brawley says ACS “stands by its recommendation that women age 40 and over should receive annual mammography” and that its recommendation that men consult with their doctors to “make an informed decision about whether or not prostate cancer early detection testing is right for them. ”
The LA Times‘ Booster Shots blog has more, as does NPR’s health blog.
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- AHCJ calls for better information from Joint Commission Web site
