Lecture 22 Mammography - EPI BYTE: NYT November 17, 2009....

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EPI BYTE: NYT November 17, 2009. Panel Urges Mammograms at 50, Not 40 Most women should start regular breast cancer screening at age 50, not 40, according to new guidelines released Monday by an influential group that provides guidance to doctors, insurance companies and policy makers. The new recommendations, which do not apply to a small group of women with unusual risk factors for breast cancer, reverse longstanding guidelines and are aimed at reducing harm from overtreatment , the group says. It also says women age 50 to 74 should have mammograms less frequently — every two years, rather than every year. And it said doctors should stop teaching women to examine their breasts on a regular basis. Just seven years ago, the same group, the United States Preventive Services Task Force , with different members, recommended that women have mammograms every one to two years starting at age 40. It found too little evidence to take a stand on breast self-examinations. Its new guidelines, which are different from those of some professional and advocacy organizations, are published online in The Annals of Internal Medicine . They are likely to touch off yet another round of controversy over the benefits of screening for breast cancer. While many women do not think a screening test can be harmful, medical experts say the risks are real. A test can trigger unnecessary further tests , like biopsies, that can create extreme anxiety . And mammograms can find cancers that grow so slowly that they never would be noticed in a woman’s lifetime, resulting in unnecessary treatment. Over all, the report says, the modest benefit of mammograms — reducing the breast cancer death rate by 15 percent — must be weighed against the harms. And those harms loom larger for women in their 40s, who are 60 percent more likely to experience them than women 50 and older but are less likely to have
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U.S. Preventive Services Task Force (USPSTF) Effects of Mammography Screening Under Different Screening Schedules Model Estimates of Potential Benefits and Harms Date: November 2009 HEALTH | NYT November 17, 2009 In Reversal, Panel Urges Mammograms at 50, Not 40 By GINA KOLATA The new recommendations, released Monday by an influential group, reverse longstanding guidelines and are HEALTH | NYT November 18, 2009 Many Doctors to Stay Course on Breast E By PAM BELLUCK Despite recommendations that women should start breast screening at 50, not 40, many doctors said they were not ready to make such a drastic change. HEALTH | NYT November 19, 2009 Breast Cancer Screening Policy Won't Ch By KEVIN SACK and GINA KOLATA The White House emphasized that the new screening standards
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Lecture 20: Mammography Case Study Learning Objectives: 1. Understand how simulations can be used to answer questions that single studies and meta-analyses cannot 2. Know what the USPSTF is and how it classifies its recommendations and strength of evidence 3. Know how to interpret the tables and findings from simulations in light of the context and assumptions in the
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Lecture 22 Mammography - EPI BYTE: NYT November 17, 2009....

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