Monday, March 29, 2010

Screening for Breast Cancer -- KC's Response

March 29, 2010

I have to tell you about our panel discussion last Wednesday night on the U.S. Preventive Services Task Force (USPSTF)’s updated recommendations concerning screening for breast cancer in the general population—the study that has clogged the blogs.

Terry Rosell and a physician at St. Luke’s drew together three doctors of differing specialties, including a breast imaging specialist who adamantly opposed the study on grounds of ethics—no authority, inexpert in skills required—a nurse, a representative from the Susan G. Komen for the Cure group, and our own Summer Johnson, AJOB editor, to discuss the ethical implications of the statement.

There was disagreement about the recommendation itself, about the study itself and about its communication to the public! But throughout the evening, the discussion was civil and enlightening.

How can one use an “evidence-based” study and its statistical findings in the one-on-one physician/patient relationship? That was the key question. Women have a right to the information which USPSTF provided (whether legitimate or not) but the interpretation of that study—or of any other—is of paramount importance. And what kind of policy decisions might be made on the basis of such studies is worrisome.

Even more worrying is the number of women who are not taking advantage of the screening process at the present time, no matter their age.

I hope some of our Center staff will report to you the insights that were of particular interest to them, but I was heartened that, to my knowledge, the Center and St. Luke’s have been the first group to present a reasoned discourse, civilly conducted, to a general audience. It is possible to argue ethics without vituperation!


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