THE PLANK NOVEMBER 20, 2009
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Wow. Big week for women: How often do both our boobs and our cervices hit the front page of the NYT?
The newly released recommendations regarding cervical-cancer screening really should not provoke anywhere near the angst and anger of the mammography debate. In this case, the science is clearer, and even the more prominent groups upset about the revised breast-cancer screening guidelines are OK with the new Pap smear ones. (Besides, cervical cancer simply doesn't terrify women en masse the way breast cancer does.)
Of course, with the health-care-reform death-match draining all sense and reason from public discource, plenty of piggish political warriors will be unable to resist pitching these recommendations as part of a fiendish government plot to balance the health care books on the reproductive systems of American women. Sarah Palin, unsurprisingly, is out in front on this.
It's like with the abortion sideshow in the reform debate: Never is the uterus so popular as when it can be wielded as a partisan tool.
Related Links:
"Another Word On The Cervix," by Marin Cogan and Seyward Darby
"The Fate of Lady Parts in the Senate Bill," by Suzy Khimm
2 comments
The debate about screening and diagnostic testing is no different than the debate about protocols in the treatment of medical conditions. We prefer medicine that is based strictly on the individual patient and the judgment of his or her physician, not on statistical analysis that measures outcomes over a large group of patients with the same symptoms and other indicators. Never mind that, as a group, patients would be better off if physicians based treatment, and the screening and diagnotic testing that precedes it, on the statistical analysis. As long as one patient can have a bad outcome by adhering to the statistical analysis (i.e., protocols), we will not accept it - even though following the "every patient is unique" approach means that, as a group, we will have more bad outcomes. A more efficient delivery of health care, lower overall costs, and better overalll outcomes. No way! That's rationing!
- raylward
November 22, 2009 at 9:06am
I know that compared to raylawrd and others with similar views, I will sound like a Neanderthal retrograde. Several years ago, my wife, with no symptoms, was diagnosed with gynecological cancer based on solely on pap smear results. She likely would not be alive today absent the early screening which she received and which she would not have received under proposed guidelines. Excuse my baby boomer narcissism. I myself had prostate cancer which was diagnosed via PSA results and a biopsy and was successfully treated. Those championing lower costs often refer to unnecessary PSA tests and biopsies, yet no basis yet exists to differentiate between slow growing and lethal carcinomas. Sometimes I wonder whether the critics of early screening people a universe in which they or family members have escaped diagnoses which saved their lives. I ask whether these writers David Leonhardt of the Times comes to mind, would opt for watchful waiting or would patriotically say - I sacrificed myself or a family member to lower costs, etc.
- thom14
November 22, 2009 at 4:58pm