Recently, the FEHBlog wrote about a New York Times article concerning a study on the value of mammography. A Wall Street Journal op-ed by two physicians explaining that
Every three or four years, a "new" announcement about the usefulness of mammograms leads to a flurry of news reports. Most recently making the rounds is an update of one Canadian study that suggested mammograms do not reduce breast cancer mortality. [The study discussed in the NY Times article.] Mammogram studies continue to yield competing results, which has led some countries such as Switzerland to discontinue recommending their regular use. Women are left to worry whether to undergo a procedure debated among doctors, expert panels and advocacy groups.The FEHBlog discussed the New York Times article with his doctor earlier this week and his doctor made the same point. The FEHBlog's concern is that the ACA's preventive care mandate like mandates is not sufficiently flexible given the science (about which the FEHBlog claims no expertise).
The confusion and angst are unnecessary. Women can find relief in reviewing what we already know about mammography: Screening works for all women 50 to 74, helping to reduce breast-cancer mortality and making treatment less onerous. Given the current data for women under 50, any age to begin mammographic screening will be controversial, but at least to us, starting at 45 seems to be a reasonable compromise.
In recognition of the HIMSS conference The FEHBlog also wrote last Sunday about a Wall Street Journal op-ed about advances in digital medicine -- virtual doctor apps. He noticed a letter to the editor from a Portland Oregon doctor who makes the point in response to this op-ed that
The things that enhance and maintain our health that have been proven effective for decades are, not surprisingly, very low-tech efforts: Eat a low-fat diet, maintain a nonobese body weight, don't smoke, use alcohol only in moderation and exercise daily.Personal responsibility is key, and it cannot be mandated.
Finally, the FEHBlog was heartened by a Wall Street Journal story published today about a teenage girl, Elana Simon, the daughter of a medical researcher, successfully helped research her own disease, a rare form of cancer.
When she turned 16, she landed an internship at a lab at Mount Sinai School of Medicine in New York through a science program at the Dalton School, a private school in Manhattan where she is a student. "I wanted to go off and be my own scientist," she said of the idea, which she pursued without consulting her father.
Her project: to compare genetic data sequenced from tissue from eight pancreatic cancer patients to hunt for mutations that might separate cancerous samples from normal ones. But the tissue was from older patients who through normal aging had accumulated thousands of harmless mutations that made spotting one or two potentially meaningful ones difficult.
For Ms. Simon, a light went on. Younger people have far fewer potentially confounding mutations. Maybe performing a similar study on tissue from young fibrolamellar patients [her disease] would yield the genetic secrets of the disease.
It did. Hope does spring eternal.