Recent Cancer Screening Changes Leave Man... (Dr. Michael V. Seiden president and CEO ...)

Recent Cancer Screening Changes Leave Many Confused

Date:11/24/2009

Dr. Michael V. Seiden, president and CEO of Fox Chase Cancer Center in Philadelphia.

Until those tools are developed, imperfect screening is going to lead to over-diagnosis and unnecessary treatment.

Still, there's no question that the revisions do fit into a larger and rapidly changing health-care picture.

"Where I think the question was solely focused on 'can you prevent cancer death?' ... 10 years ago or 20 years ago, I think there has been a much more open dialogue about the burden of screening, the cost burden, the anxiety burden, the false-positive burden," Seiden said. "As screening techniques become more sensitive, you do a better and better job of capturing people with cancer but you also do a better job of capturing people with tumors they might not have died from. So, all of a sudden the incidence of pre-malignant breast disease, the incidence of low-grade prostate cancer, starts doubling and the death rate drops, but only very, very modestly."

While the USPSTF stated that cost considerations had nothing to do with the new breast cancer recommendations announcement, ACOG did mention costs in its announcement regarding changes to cervical cancer screening.

"In this country, health care is an enormous issue and it is the single greatest driver of the national debt," Brooks said. "There's nothing wrong with raising financial questions in a public health setting."

"It's my belief that the task force just set the date [for its announcement] and wasn't really paying attention to the politics. In truth, I don't know but . . . part of the way of controlling costs is the rational use of medical care, not the rationing of care," Brawley said. "For most women in the U.S., to get a Pap smear on an annual basis means that we're going to spend three times more on cervical cancer screening than we need to spend and we've actually gotten evidence that screening tests every five years is going to save as man
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