Thank you for the calm discourse. I agree they don't know everything. And they don't know what treatments in the works now will change the ability to deal with this disease tomorrow.
Futhermore, if it were as simple as cancers that pose no threat or cancers that are untreatable no matter when they are discovered, screening would be irrelevant at any age.
Again..I can see this kind of think at least being floated in older patients with "comorbidities". (I hate that %&^%& word) i have seen frst hand the misjudgement of co-morbidities as well.
Avoiding early detection in younger patients is like saying they have either harmless cancer or cancer that won't benefit from early detection/early treatment. I'd have to see something that spells that out convincingly. And even then it would be based on the equations and paradigms of the past. Let's give young women, and their future treatment teams, the benefit of the doubt. Maybe some better diagnostic tools could help too:
Thermography preferable to mammography
Women with a continued interest in breast cancer screening would do well to choose thermography rather than mammography. Thermography utilizes digital infrared imaging, a safe detection method that analyzes body heat levels in and around the breasts. By analyzing blood vessel circulation and metabolic changes that typically accompany the onset of tumorous growths, thermography is arguably the most effective, accurate, and safest breast cancer detection method.
Her2-ers here were battling against statistical odds long before T-DM1 was a glimmer in anyone's eye.
In terms of the sell of the idea, I was suggesting the general public is going to have some difficulty switching from a being drilled on the importance of mammograms to being told they don't benefit younger patients.
But what do I know? And what will they know tomorrow?
Here's what I saw today:
Cancer Epidemiol Biomarkers Prev. 2009 Mar;18(3):718-25. Epub 2009 Mar 3.
Cost-effectiveness analysis of mammography and clinical breast examination strategies: a comparison with current guidelines.
Ahern CH,
Shen Y.
Department of Medicine, The Dan L. Duncan Cancer Center at Baylor College of Medicine, Houston, TX 77030-4009, USA.
PURPOSE: Breast cancer screening by mammography and clinical breast exam are commonly used for early tumor detection. Previous cost-effectiveness studies considered mammography alone or did not account for all relevant costs. In this study,
we assessed the cost-effectiveness of screening schedules recommended by three major cancer organizations and compared them with alternative strategies. We considered costs of screening examinations, subsequent work-up, biopsy, and treatment interventions after diagnosis. METHODS: We used a microsimulation model to generate women's life histories, and assessed screening and treatment effects on survival. Using statistical models, we accounted for age-specific incidence, preclinical disease duration, and age-specific sensitivity and specificity for each screening modality. The outcomes of interest were quality-adjusted life years (QALY) saved and total costs with a 3% annual discount rate. Incremental cost-effectiveness ratios were used to compare strategies. Sensitivity analyses were done by varying some of the assumptions. RESULTS:
Compared with guidelines from the National Cancer Institute and the U.S. Preventive Services Task Force, alternative strategies were more efficient. Mammography and clinical breast exam in alternating years from ages 40 to 79 years was a cost-effective alternative compared with the guidelines, costing $35,500 per QALY saved compared with no screening. The American Cancer Society guideline was the most effective and the most expensive, costing over $680,000 for an added QALY compared with the above alternative. CONCLUSION: Screening strategies with lower costs and benefits comparable with those currently recommended should be considered for implementation in practice and for future guidelines.
PMID: 19258473 [PubMed - indexed for MEDLINE]