“The findings suggest breast cancer screenings lead to overdiagnosis because they mainly catch smaller tumors, the researchers say.”
“We were troubled that we did not see evidence of a mortality benefit from screening, especially because there was no relationship between screening and advanced-stage cancer, either,” Harding said.”
This is typical relatively worthless outcomes analysis drivel that the clueless policy wonks in DC and academia (e.g. Gruber) love to quote.
1) Of course mammograms aren't going to increase the diagnosis of large tumors, since those are most often evident without the need for a mammogram.
2) How does early detection of ‘small’ tumors equate to “over-diagnosis”? You mean catching it before it becomes big and advanced is "over-diagnosis" and not preferable?
3) The study doesn't distinguish between mammography vs no mammography. It looks at the effects of a 10% increase in screening rate, and determines this increased screening catches an additional 16% of breast cancer - generally in its earlier stages. With those statistics, and given the other myriad co-variables, the bigger surprise would be if those numbers did show a definitive mortality benefit. Further, did catching the tumors at an earlier stage lead to more lumpectomies vs mastectomies? Less adjuvant chemo? etc. etc.
The bottom line is that outcomes analysis is a quasi-scientific field in its juvenile stages, often dependent upon the accuracy of large government-kept databases, and quite limited in its ‘predictive’ value (i.e. it's easier to make proclamations about what you think data show about what has already happened than it is to use that data to predict what will happen in the future if you alter practice patterns).
Despite all these limitations, these types of studies are increasingly determining what kind of care you'll receive, and whether or not it will be paid for.
Yes. This is the kind of thing Obamacare is MEANT to do, reduce access to healthcare, ironically while theoretically making it available to more people.
More expensive, less available, as we are finding out. As if that couldn’t have been predicted.