The American Cancer Society says new research supports changing the age at which most women should start getting yearly mammograms. But the group’s latest advice still conflicts with other guidance.
By Sandra G. Boodman
It’s the latest battle over screening: Should healthy women skip annual pelvic exams?
A controversial recommendation last year by the American College of Physicians, which represents the nation’s internists, strongly urged that doctors stop routinely performing the invasive exam on women without symptoms and who are not pregnant.
Citing 60 years of research, the ACP found no evidence that the screening, performed about 63 million times annually at a cost of approximately $2.6 billion, detects cancer or other serious conditions.
The exam, researchers reported, did cause harm: One-third of women reported discomfort, pain, embarrassment or anxiety — leading some to avoid care altogether.
For roughly 1 percent of women, a suspicious finding triggered a cascade of anxiety-provoking interventions — including tests and surgery, which carry a risk of complications for conditions that nearly always turned out to be benign.
The controversy underscores the difficulty of changing long-established clinical practice and raises questions about the role of payment in shaping physician behavior.
Patients expect it, the group said, and the screening builds trust, reassures women and encourages them to discuss sensitive matters such as sexual dysfunction. A decision about whether to undergo the exam should be made by doctors and patients, ACOG concluded.
These dueling recommendations leave women in the unenviable position of sorting out what to do. Continue reading
By Jordan Rau
Thinking about getting a mammogram in the Dallas-Fort Worth area? You might check carefully because the cost can vary from $50 to as much as $1,045.
How about an initial routine gynecological exam? Around Phoenix, those prices can range from $72 to $388.
According to an analysis released Wednesday, it can pay to shop around for women’s health care, with mammograms and other routine services often costing far more in one office than in another. Continue reading
By Julie Appleby
As health insurance open season heats up for businesses across the country, many employees will discover that participating in their company’s wellness program includes rolling up their sleeves for blood tests.
Half of large employers offering health benefits have wellness programs that ask workers to submit to medical tests, often dubbed “biometrics,” that can involve a trip to a doctor’s office, lab or workplace health fair.
Will the screening exams actually improve health, or merely add to a culture of over-testing that is helping drive up the cost of health care?
So far, research is mixed on whether these programs truly save employers money. The Rand Corp. says most don’t, with the exception of programs targeted at managing specific diseases, such as diabetes. Still, Rand found that programs can help spur employees to quit smoking, get more exercise and lose a bit of weight. Continue reading
By Julie Appleby
Almost every American will experience a medical diagnostic error, but the problem has taken a back seat to other patient safety concerns, an influential panel said in a report out today calling for widespread changes.
Diagnostic errors — defined as inaccurate or delayed diagnoses — account for an estimated 10 percent of patient deaths, hundreds of thousands of adverse events in hospitals each year and are a leading cause of paid medical malpractice claims, a blue ribbon panel of the Institute of Medicine (IOM) said in its report.
Photo courtesy of Sanja Gjenero
Inspectors are being asked to pay greater attention following analysis showing mistakes resulting in injuries and deaths
The federal government is asking health inspectors nationwide to be on the lookout for errors by nursing homes in managing the blood thinner Coumadin, including those that lead to patient hospitalizations and deaths.
In a memo sent last month to state health departments, the Centers for Medicare and Medicaid Services cited a report by ProPublica and The Washington Post that focused on the harm caused by homes’ failure to manage the drug.
In some cases, homes gave residents too much of the drug, which caused internal bleeding. In other cases, they gave residents too little, leading to blood clots and strokes.
In some cases, homes gave residents too much of the drug, which caused internal bleeding. In other cases, they gave residents too little, leading to blood clots and strokes. Continue reading
By Michelle Andrews
Requiring patients to get blood work and other tests before undergoing cataract surgery hasn’t been recommended for more than a dozen years.
There’s good reason for that: The eye surgery generally takes less time than watching a rerun of “Marcus Welby, MD” — just 18 minutes, on average.
“It’s so low risk it’s almost like saying you’re going to get your nails done.”
FACTS AND MYTHS –
By the US Preventive Services Task Force
MYTH: The Task Force recommends against screening for breast cancer in women younger than 50.
FACT: Evidence shows that mammography screening can be effective for women in their 40s. Based on the science, the Task Force’s draft recommendation states that the decision to start regular mammography screening before age 50 is an individual one and should be made by a woman in partnership with her doctor. Continue reading
By Barbara Feder Ostrov
Earlier this year, Caryn Hoadley received an unexpected letter after a routine mammogram.
The letter said her mammogram was clean but that she has dense breast tissue, which has been linked to higher rates of breast cancer and could make her mammogram harder to read.
“I honestly don’t know what to think about the letter,” said Hoadley, 45, who lives in Alameda, Calif. “What do I do with that information?”
Millions of women like Hoadley may be wondering the same thing. Twenty-one states, including California, have passed laws requiring health facilities to notify women when they have dense breasts. Eleven other states are considering similar laws and a nationwide version has been introduced in Congress.
The laws have been hailed by advocates as empowering women to take charge of their own health. About 40 percent of women have dense or extremely dense breast tissue, which can obscure cancer that might otherwise be detected on a mammogram.
But critics say the laws cause women unnecessary anxiety and can lead to higher costs and treatment that doesn’t save lives or otherwise benefit patients. Continue reading
Expanding diabetes screening in adults to catch the disease early does not appear to keep people from dying of cardiovascular causes, according to a report designed to help shape U.S. treatment guidelines.
Earlier detection did seem to slow the progression of so-called prediabetes to full-blown diabetes, but it had no impact on the risk of death from heart or blood vessel disease 10 years later, researchers found when they analyzed studies conducted from 2007 to 2014.
Seattle Children’s hospital and Mayo Medical Laboratories are creating a partnership to develop ways for children’s hospitals around the country to decrease costs and errors that come from unnecessary lab testing.
From WBUR’s CommonHealth:
A new Brigham and Women’s Hospital study finds that we may not need quite as much genetic counseling as we’d thought. Particularly on relatively cut-and-dried findings, like test results on a common gene that raises the risk of Alzheimer’s disease. Listen to WBUR host Anthony Brooks speak with Dr. Robert C. Green:
Workers with Service Employees International Union Healthcare 1199NW say they’re worried they lack training in the proper procedures for cleaning rooms to manage Ebola patients.
Nurses and housekeepers at some hospitals say this reduces front-line defense against infectious diseases.