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NPR's Scott Simon Shares His Take On Events Large And Small

Rolling The Dice On Mammograms

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A man should be careful talking about mammograms. But the report issued this week by a panel of doctors who recommend less frequent testing for breast cancer in women younger than 50 comes as Congress and the country debate health care coverage.

Since the report came out, news accounts and blogs have featured hundreds of personal stories from women in their 40s who say — just this bluntly — that these new guidelines would have killed them by letting their cancer grow without detection.

I know enough about mammograms to know that they're not marshmallow treats. They're painful and humiliating tests that squash a woman where it hurts most. Most men — myself included; maybe even Daniel Craig included — would cringe to have a mammogram.

And when the results are what they call "false positive," a week or more of worry and anxiety follow, along with a stinging biopsy. It's good news if nothing is found but still a punishing experience. I can understand why a lot of women would almost welcome a medical excuse to avoid an annual mammogram.

The Washington Post ran a piece Friday by two physicians who worked with the doctors task force. Douglas Kamerow at Georgetown University and Steven Woolf at Virginia Commonwealth defended their recommendation, noting that every 1,900 screenings in women ages 39 to 49 produced just one case in which cancer was discovered and arrested.

They suggested that between bad results and biopsies, annual tests lead to a lot more worry and pain than cures — and, yes, cost a lot of money that might be directed elsewhere.

Of course, what if you are that one woman in 1,900? Or that one woman is your wife or mother? And if you screen just 1 million women between the ages of 39 and 49, statistics suggest that you may catch cancer before it can grow in 526 women.

Maybe we shouldn't be shocked to think that some doctors might find the chance to save one life in 1,900 to be a small result for so much effort. A lot of us play with our odds of survival by smoking, overeating or talking on the phone while driving.

People on all sides of the health care debate like to talk about how money can be saved in their particular plan by reducing the number of medical tests that seem redundant or unnecessary. This week, we may have seen what happens when someone suggests a way to actually do that. A lot of people decide they can't live with that.



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Simon Says

Simon SaysSimon Says

NPR's Scott Simon Shares His Take On Events Large And Small

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