Thursday, November 19, 2009

Singing Mammograms

When the U.S. Preventive Services Task Force (or USPSTF, which is really hard to say when you're drunk) suggested that routine mammograms aren't necessary for women under 50, who knew so many folks would get their tits stuck in a wringer. And, yes, that also applies to manboobs.

"Outrageous," they scream. "Unbelievable," they wail. "Women are going to die," they yell as they tear at their clothes.

Well, no, not really and yes but not in any significantly higher numbers than before.

When on Facebook, my husband had the audacity to attempt mob control by introducing a little Freakonomics into the discussion, he found himself in a cyber shit storm. Here's part of his defense.
Actually, you might be missing the point of the Task Force's directive. In the past, considering the cost of mammograms, the resources used, the amount of cancer "caught" by such tests, it was thought that women should start getting regular mammograms starting at age 40. After examination of the stats, however, the policy of recommending them at that age has been found to be a bit too... cautious (for lack of a better word).

My point (which might have been missed) is this: No woman has to listen to the guidelines. No one said that women under 50 will be refused the test. No one.

It's not idiotic at all-- it's unemotional, it's based on stats, it's put forward with an eye toward efficiency and it is based also on cost-benefit ratios.

The reaction-- skepticism, anger and concern-- is out of proportion. The simple fact remains that we're talking about a couple hundred bucks. Some folks spend more than that at Applebee's in the course of a year.

My lovely wife pays for her own mammograms (she's 44) and will continue to do so until age 50 and beyond. It's worked into our budget. (She got her first one on the house from the Camden County Cancer Screening Project and her next one will be half-price-- probably $80-- in October, which is Breast Cancer Awareness Month.)

Currently, women have a choice if they wish to buck the guidelines. However, that may not be the case if healthcare is "reformed." In the not too distant future, we'll actually be forced to adhere to the guidelines-- there will be no such choice. (So, it has everything to do with "money and the healthcare debate.")
The dude makes several good points-- which is why I married him.

We all have a relative or a friend or a relative of a friend or a friend of a relative who has been diagnosed with breast cancer before the age of 50. But, in many of those cases, the woman was at high risk to begin with.

The word that seems to be lost in this whole debate is "routine." These guidelines are for routine mammograms. Women with a family history or genetic mutation should be screened earlier. Any good doctor would recommend-- perhaps even insist-- on such a course of action.

Woman who aren't high risk but are fearful of being the "exception to the rule" can get a mammogram anyway since these are guidelines and not laws.

However, even supporters of a government run healthcare system will admit that rationing is a necessary evil in order to control costs. Women under 50 and over 75 will be waaaaaaaaay in the back of the mammogram line. Those of us who are high risk will no doubt be ranked in the order of our riskiness.

Right now we can get our boobs squashed by handing over wads of cash. In the future, we may get carpal tunnel syndrome from keeping our fingers crossed.

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