Term Paper on "New Breast Cancer Screening Guidelines"

Term Paper 8 pages (2607 words) Sources: 10

[EXCERPT] . . . .

New breast cancer screening guidelines is an important topic because it affects all women. Not only does it affect women, it affects their children and other family members and friends. Breast cancer is a serious disease and the new guidelines appear to have taken us a step backwards instead of moving us forward in our efforts to continue to decrease the mortality rate. The new guidelines suggest that women get their first breast exam at the age of fifty instead of forty. Specifically, the new breast screening guidelines established by the United States Preventative Services Task Force (USPSTF) determined in November of 2009 that routine screening should begin at the age of fifty instead of forty and that clinical as well as self breast exams are scaled back. The established guideline of a screening every other year for women in their fifties and sixties has not changed.(6)

If healthcare providers adhere to these new guidelines, many women in their forties and younger are being placed at risk since early detection is no longer an option. Breast cancer screening is an effective way of early detection and in most cases this screening can detect the early stages of cancer even before the patient discovers that small lump while performing a breast self-exam. Breast cancer is one of the leading causes of death in women and previous guidelines must be taken seriously. The Susan G. Komen for the Cure organization does not agree with the new guidelines and feel that the age for the start of breast cancer screening should remain at forty.(1) The USPSTF has also stated that women as well as their physicians should cut back on performing breast self-examinations. This does not appear to be a good idea and seems to be steering women away from taking charge of their own health. A physician would only perform this examination approximately once a year at the time of the patient's annual exam, but in the past, women have been encouraged to perform breast self-examinations at least once a month. These once a month self-examinations could play an extremely large and important role in early detection. Many women (young and older) have discovered small lumps in their breast long before they were due for a mammogram.

It does not make sense to scale back on every aspect of the guidelines. If women are being encouraged to begin with regular mammograms at the age of fifty, they most certainly should not be discouraged from performing self-examinations. If all viable options regarding this issue are being discouraged, this leaves women open to threat of getting breast cancer and not finding out about it until it is too late. The mortality rate would increase for sure and then the USPSTF will need to go back to recommending the previous guidelines.

This topic was chosen because of the potential negative impact it can have on early detection and survival rates from the disease. Breast cancer can happen in men, but it is rare. The majority of victims of this disease are women as therefore, women must come together collectively and challenge the new guidelines. Our voices must be heard so we can move toward forcing the USPSTF to establish guidelines that benefit us and not work against us. Also, everyone needs to be concerned about how these new guidelines will affect them. Most everyone has had a mother, sister, aunt, cousin or other relative that is either a breast cancer survivor or a loved one that has succumbed to the disease.

History

Regular breast cancer screening began in 1990 and since then the morality rate has declined thirty percent.(1) This steady decline in mortality is proof positive that we were headed in the right direction with the previous guidelines for screening. Back in the early 1990's, many efforts were made to instill in women the importance of regular mammograms. At this stage, women still feared excessive exposure to radiation from mammograms as well as the possibility of an inaccurate reading. When it comes to preventative health, those in the medical professions should always consider consumers and their views on the subject. Whether or not consumers trust the decisions of health care providers and how they process scientific data play a large role in the choices they make regarding their health.(9)

According to Dr. Robb-Nicholson, 192,370 cases of breast cancer occurred in 2009 and of this number, 40,170 women died from the disease. She states that since 1990, there has been a steady decline in the mortality rate of two percent per year. (6) The USPSTF decided to update the breast cancer screening guidelines based on a meta analysis and decision analysis. The analysis showed that the risk of breast cancer was greater in women over fifty years of age than those younger than this. They also determined that a very small number of women younger than forty benefit from regular breast cancer screening. (3,4) Because of these determinations, the new guidelines were established.

Analysis

Many physicians and healthcare professionals recommend that women follow the previous screening guidelines. They also encourage women to continue with breast self-exams even though evidence shows that these self-exams do not increase breast cancer detection. (2) Given this, it is still imperative that women make informed decisions regarding their health for themselves. Because of the steady decrease in mortality in those who get regular screenings over the years, the guidelines should not have changed.

The USPSTF seem to base their decision to change the guidelines on statistics that aren't large enough to justify these changes. This organization has not taken into account the statistics from other organizations aimed at preventing, or at the very least, decreasing the mortality rate of women with the disease. Their decision for the change could be based on several factors. One of them is the cost effectiveness of annual screenings. With the many issues this country is facing with healthcare, some procedures may be seen as less important than others. If this is the case, even the slightest and most minute bit of evidence showing a trend towards the possible need to decrease annual screenings may have been a factor in the USPSTF to make a hurried decision which will no doubt affect thousands of women. However, it remains a fact that breast cancer is the second leading cause of avoidable death among women.(5)

The new breast cancer guidelines affect the healthcare discipline in several ways. One way is that it will force patients to become more aware and thus take control of their health as opposed to relying on a healthcare professional to instruct them on the issue. If patients have a family history of breast cancer, they must take it upon themselves to get regular screenings and perform monthly self-examinations and not rely on the current guidelines. Patients must take charge and be in control of their own health.

Another way that this issue affects the healthcare discipline is that there is a possibility that there may be an increase in the rate of breast cancer among women, especially with women who normally have to be prodded into getting regular exams. Young women, (those under forty years of age), may be lulled into a false sense of security based on the new guidelines and feel that they won't need a mammogram until they reach the age of fifty. Statistics have shown that by the age of forty, one in 217 women will develop breast cancer. Studies have also shown that African-American women and women from low-income households are less likely to get mammograms as are women of other races. Women in this category normally may have at least one mammogram, but many need to be reminded and encouraged by their healthcare professional to continue with regular screenings. (7, 8) These new guidelines do very little to reinforce the fact that annual breast screening is important.

Future

A major scenario that could possibly unfold is that health insurance companies may adhere to the new guidelines and instead of covering the cost of one mammogram per year beginning at age forty, they may decide that they will only pay for one mammogram per year beginning at the age of fifty. This will pose major health implications for women who are susceptible to the disease. If this scenario were to play out, women will need to find an alternative way of affording the screening that they need during the year that the insurance company does not pay for.

Another scenario is that monies could be drastically reduced for programs that are federally funded to help low income women obtain the health services they need such as regular breast screening. This could cause major issues across economic lines because if funding is cut, women from low income families may not receive the necessary screening. Saywell, et.al did a study on cost-effective methods to get the word out to women of color and those from low-income households on the importance of getting regular screenings. (8) If funding is cut… READ MORE

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