WHAT THE SCIENTISTS ARE IGNORING...:

Guidelines Push Back Age for Cervical Cancer Tests (DENISE GRADY, 11/20/09, NY Times)

[Dr. Cheryl B. Iglesia, the chairwoman of a panel in the obstetricians’ group that developed the Pap smear guidelines] said the argument for changing Pap screening was more compelling than that for cutting back on mammography — which the obstetricians’ group has staunchly opposed — because there is more potential for harm from the overuse of Pap tests. The reason is that young women are especially prone to develop abnormalities in the cervix that appear to be precancerous, but that will go away if left alone. But when Pap tests find the growths, doctors often remove them, with procedures that can injure the cervix and lead to problems later when a woman becomes pregnant, including premature birth and an increased risk of needing a Caesarean.

...is that modern medicine is a consumer good. People just don't care what makes medical sense. Just because a procedure has no health benefit and is a dangerous waste of money doesn't mean patients won't demand it.

MORE:
Culture Clash in Medicine (KEVIN SACK, 11/20/09, NY Times)

“This represents a broader understanding that the efforts to detect cancer early can be a two-edged sword,” said Dr. H. Gilbert Welch, a professor of medicine at Dartmouth who is among the pioneers of research into the negative effects of early detection. “Yes, it helps some people, but it harms others.”

Dr. Welch said this week’s recommendations could mark a turning point in public acceptance of that notion. “Now we’re trying to negotiate that balance,” he said. “There’s no right answer, but I can tell you that the right answer is not always to start earlier, look harder and look more frequently.”

That concept is proving easier to swallow in the halls of Dartmouth Medical School than in the halls of Congress

Posted by Orrin Judd at November 20, 2009 6:08 AM