Just Say No: Doctors' Groups Define More Unnecessary Tests, Procedures
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Since 2011, she's been writing and editing stories for the site. Before taking up blogging, she toiled for many years (more than we can count) producing health stories for television, including\u003cem> Dateline NBC\u003c/em> and San Francisco's CBS affiliate, KPIX-TV. She also wrote up a \u003ca title=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\">handy guide to the Affordable Care Act\u003c/a>, especially for Californians. Her work has been honored for many awards. Most recently she was a finalist for \"Best Topical Reporting\" from the Online News Association. You can follow her on Twitter: \u003ca title=\"https://twitter.com/laliferis\" href=\"https://twitter.com/laliferis\">@laliferis\u003c/a>","avatar":"https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=blank&r=g","twitter":"laliferis","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["subscriber"]},{"site":"futureofyou","roles":["subscriber"]},{"site":"stateofhealth","roles":["subscriber"]},{"site":"science","roles":["subscriber"]},{"site":"food","roles":["contributor"]}],"headData":{"title":"Lisa Aliferis | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/lisaaliferis"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"stateofhealth_10710":{"type":"posts","id":"stateofhealth_10710","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"10710","score":null,"sort":[1361484020000]},"guestAuthors":[],"slug":"just-say-no-doctors-groups-define-more-unnecessary-tests-procedures","title":"Just Say No: Doctors' Groups Define More Unnecessary Tests, Procedures","publishDate":1361484020,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_10715\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/21/just-say-no-doctors-groups-define-more-unnecessary-tests-procedures/ct-scan-13-of-clubs_flickr/\" rel=\"attachment wp-att-10715\">\u003cimg class=\"size-medium wp-image-10715\" title=\"Don't automatically do a CT scan on a child with a minor head injury. (13 of Clubs/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/CT-scan-13-of-Clubs_Flickr-300x225.jpg\" alt=\"CT scan 13 of Clubs_Flickr\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">One new recommendation: Don't automatically do a CT scan to check a child's minor head injury. (13 of Clubs/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>One of the rallying cries against fee-for-service medicine is this: since doctors are paid to do things to patients (tests, procedures), they are then incentivized to do more things to patients (tests, procedures) than the patient might actually need.\u003c/p>\n\u003cp>On Thursday, a wide swath of medical groups joined a campaign to list tests and procedures which are commonly done but risk causing patients more harm than benefit.\u003c/p>\n\u003cp>This \"\u003ca href=\"http://www.choosingwisely.org\" target=\"_blank\">Choosing Wisely\u003c/a>\" campaign is from a coalition of doctors' groups -- ranging from the American Academy of Pediatrics to the Society of Thoracic Surgeons -- in conjunction with Consumer Reports.\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/04/05/please-dont-call-it-rationing/\" target=\"_blank\"> Last year\u003c/a>, the campaign named 45 tests and procedures patients should look at carefully. This year, 17 doctors' organizations representing 350,000 physicians released \u003ca href=\"http://www.choosingwisely.org/wp-content/uploads/2013/02/021513_CW-Phase-II-Press-Release-FINAL.pdf\" target=\"_blank\">90 additional tests and procedures.\u003c!--more-->\u003c/a>\u003c/p>\n\u003cp>The goal is to encourage patients and doctors to consider what care is truly necessary, to understand “that when it comes to health care, more is not necessarily better,” Dr. \u003ca href=\"http://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_57.html\">Christine Cassel\u003c/a> of the ABIM Foundation said in a statement.\u003c/p>\n\u003cp>Here are just a few examples of some of their recommendations:\u003c/p>\n\u003cdiv>\n\u003cul>\n\u003cli>Don’t induce labor or schedule a c-section before 39 weeks pregnancy without a valid medical reason. Delivery before 39 weeks is associated with increased risk of learning disabilities and respiratory problems. (American College of Obstetricians and Gynecologists; American Academy of Family Physicians)\u003c/li>\n\u003cli>Don’t use feeding tubes in patients with advanced dementia. It does not result in better outcomes. Studies show that helping with eating is a better, evidence-based approach. (American Academy of Hospice and Palliative Medicine; American Geriatrics Society)\u003c/li>\n\u003cli>Don’t automatically do a CT scan to check a child's minor head injury. Roughly half of children who visit hospital emergency departments with head injuries are given a CT scan. CT scanning is associated with radiation exposure that may increase future cancer risk. Doctor should observe a child prior to making a decision about needing a CT. (American Academy of Pediatrics)\u003c/li>\n\u003c/ul>\n\u003cp>Fifteen more medical societies are expected to release new or additional lists later this year.\u003c/p>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n","blocks":[],"excerpt":"One of the rallying cries against fee-for-service medicine is this: since doctors are paid to do things to patients (tests, procedures), they are then incentivized to do more things to patients (tests, procedures) than the patient might actually need.\r\n\r\nOn Thursday, a wide swath of medical groups joined a campaign to list tests and procedures which are commonly done but risk causing patients more harm than benefit. The goal is to encourage patients and doctors to consider what care is truly necessary.","status":"publish","parent":0,"modified":1361521394,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":8,"wordCount":370},"headData":{"title":"Just Say No: Doctors' Groups Define More Unnecessary Tests, Procedures | KQED","description":"One of the rallying cries against fee-for-service medicine is this: since doctors are paid to do things to patients (tests, procedures), they are then incentivized to do more things to patients (tests, procedures) than the patient might actually need.\r\n\r\nOn Thursday, a wide swath of medical groups joined a campaign to list tests and procedures which are commonly done but risk causing patients more harm than benefit. The goal is to encourage patients and doctors to consider what care is truly necessary.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"10710 http://blogs.kqed.org/stateofhealth/?p=10710","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/02/21/just-say-no-doctors-groups-define-more-unnecessary-tests-procedures/","disqusTitle":"Just Say No: Doctors' Groups Define More Unnecessary Tests, Procedures","path":"/stateofhealth/10710/just-say-no-doctors-groups-define-more-unnecessary-tests-procedures","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_10715\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/21/just-say-no-doctors-groups-define-more-unnecessary-tests-procedures/ct-scan-13-of-clubs_flickr/\" rel=\"attachment wp-att-10715\">\u003cimg class=\"size-medium wp-image-10715\" title=\"Don't automatically do a CT scan on a child with a minor head injury. (13 of Clubs/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/CT-scan-13-of-Clubs_Flickr-300x225.jpg\" alt=\"CT scan 13 of Clubs_Flickr\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">One new recommendation: Don't automatically do a CT scan to check a child's minor head injury. (13 of Clubs/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>One of the rallying cries against fee-for-service medicine is this: since doctors are paid to do things to patients (tests, procedures), they are then incentivized to do more things to patients (tests, procedures) than the patient might actually need.\u003c/p>\n\u003cp>On Thursday, a wide swath of medical groups joined a campaign to list tests and procedures which are commonly done but risk causing patients more harm than benefit.\u003c/p>\n\u003cp>This \"\u003ca href=\"http://www.choosingwisely.org\" target=\"_blank\">Choosing Wisely\u003c/a>\" campaign is from a coalition of doctors' groups -- ranging from the American Academy of Pediatrics to the Society of Thoracic Surgeons -- in conjunction with Consumer Reports.\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/04/05/please-dont-call-it-rationing/\" target=\"_blank\"> Last year\u003c/a>, the campaign named 45 tests and procedures patients should look at carefully. This year, 17 doctors' organizations representing 350,000 physicians released \u003ca href=\"http://www.choosingwisely.org/wp-content/uploads/2013/02/021513_CW-Phase-II-Press-Release-FINAL.pdf\" target=\"_blank\">90 additional tests and procedures.\u003c!--more-->\u003c/a>\u003c/p>\n\u003cp>The goal is to encourage patients and doctors to consider what care is truly necessary, to understand “that when it comes to health care, more is not necessarily better,” Dr. \u003ca href=\"http://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_57.html\">Christine Cassel\u003c/a> of the ABIM Foundation said in a statement.\u003c/p>\n\u003cp>Here are just a few examples of some of their recommendations:\u003c/p>\n\u003cdiv>\n\u003cul>\n\u003cli>Don’t induce labor or schedule a c-section before 39 weeks pregnancy without a valid medical reason. Delivery before 39 weeks is associated with increased risk of learning disabilities and respiratory problems. (American College of Obstetricians and Gynecologists; American Academy of Family Physicians)\u003c/li>\n\u003cli>Don’t use feeding tubes in patients with advanced dementia. It does not result in better outcomes. Studies show that helping with eating is a better, evidence-based approach. (American Academy of Hospice and Palliative Medicine; American Geriatrics Society)\u003c/li>\n\u003cli>Don’t automatically do a CT scan to check a child's minor head injury. Roughly half of children who visit hospital emergency departments with head injuries are given a CT scan. CT scanning is associated with radiation exposure that may increase future cancer risk. Doctor should observe a child prior to making a decision about needing a CT. (American Academy of Pediatrics)\u003c/li>\n\u003c/ul>\n\u003cp>Fifteen more medical societies are expected to release new or additional lists later this year.\u003c/p>\n\u003c/div>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/10710/just-say-no-doctors-groups-define-more-unnecessary-tests-procedures","authors":["240"],"categories":["stateofhealth_14"],"tags":["stateofhealth_235","stateofhealth_236","stateofhealth_86"],"label":"stateofhealth"},"stateofhealth_10370":{"type":"posts","id":"stateofhealth_10370","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"10370","score":null,"sort":[1360076456000]},"guestAuthors":[],"slug":"mammograms-strong-evidence-that-every-two-years-is-best-option-for-older-women","title":"Mammograms: Strong Evidence That Every Two Years Is Best Option For Older Women","publishDate":1360076456,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_5549\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/05/01/new-research-for-women-in-their-40s-on-mammograms/080922-n-2688m-004/\" rel=\"attachment wp-att-5549\">\u003cimg class=\"size-medium wp-image-5549\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-300x203.jpg\" alt=\"(Photo: U.S. Navy)\" width=\"300\" height=\"203\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: U.S. Navy)\u003c/figcaption>\u003c/figure>\n\u003cp>A major new study has found that -- in older women -- mammograms done every two years were as effective as mammograms done annually and led to far fewer false positive results.\u003c/p>\n\u003cp>\u003ca href=\"http://jnci.oxfordjournals.org/content/early/2013/02/01/jnci.djs645.abstract\" target=\"_blank\">The study\u003c/a>, published online Tuesday in the Journal of the National Cancer Institute, included more than 140,000 women ages 66 to 89 from across the country.\u003c/p>\n\u003cp>Frequency of mammograms among women in their 40s and 50s has been the subject of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/05/01/new-research-for-women-in-their-40s-on-mammograms/\" target=\"_blank\">intense debate\u003c/a> for more than two decades, but this older group of women has been much less studied.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The women screened annually had a dramatically higher rate of false positives.\u003c/aside>\n\u003cp>A team led by researchers at UC San Francisco sought to answer the question: among older women, if a woman is screened for breast cancer every two years, instead of every year, will a deadly cancer be missed?\u003c/p>\n\u003cp>\"We found that there really was no difference,\" Dejana Braithwaite, assistant professor of cancer epidemiology at UCSF and part of the research team, told me. \"The women who were screened every two years were not at a greater risk. They did not have a higher probability of being diagnosed with late stage breast cancer compared to those women who were screened every year.\"\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In addition, the women screened annually had a dramatically higher rate of false positives; they were called back for unnecessary mammograms or biopsies. In the study, nearly half of women screened annually -- 48 percent -- had a false positive over a 10-year period, versus about 29 percent of women screened every two years.\u003c/p>\n\u003cp>\"The overall message is that the probability of false positive results is much greater with annual screening and yet there is no added benefit,\" Braithwaite said.\u003c/p>\n\u003cp>The U.S. Preventive Services Task Force created a firestorm of controversy in 2009 when it said women ages 50 to 74 should be screened every two years instead of annually. At that time,\u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm\" target=\"_blank\"> the task force said that\u003c/a> \"the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older.\" Braithwaite says today's study is one step toward advancing the evidence.\u003c/p>\n\u003cp>\"It doesn't mean to say that women in (their) 70s and even in their 80s should not be screened. Indeed, if they are in good health -- women in their 70s -- there is not reason for them not to be screened.\" But if they have other health issues, breast cancer screening could end up causing unnecessary harms.\u003c/p>\n\u003cp>\"So there's a lot of uncertainty about the value of screening in these older age groups, and that's why we're trying to address is this gap of information in evidence,\" Braithwaite said.\u003c/p>\n\u003cp>And as the population ages, it's becoming an \"increasingly important question,\" she concluded.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to the story\u003c/strong>:\u003cbr>\n[audio:http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/Mammograms-in-Older-Women.mp3]\u003c/p>\n\n","blocks":[],"excerpt":"A major new study has found that -- in older women -- mammograms done every two years are as effective as mammograms done annually and led to far fewer false positive results.\r\n\r\nThe study, published today in the Journal of the National Cancer Institute, included more than 140-thousand women ages 66 to 89 from across the country. Frequency of mammograms among women in their 40s and 50s has been the subject of intense debate for more than two decades, but this older group of women has been much less studied.","status":"publish","parent":0,"modified":1371247057,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":14,"wordCount":492},"headData":{"title":"Mammograms: Strong Evidence That Every Two Years Is Best Option For Older Women | KQED","description":"A major new study has found that -- in older women -- mammograms done every two years are as effective as mammograms done annually and led to far fewer false positive results.\r\n\r\nThe study, published today in the Journal of the National Cancer Institute, included more than 140-thousand women ages 66 to 89 from across the country. Frequency of mammograms among women in their 40s and 50s has been the subject of intense debate for more than two decades, but this older group of women has been much less studied.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"10370 http://blogs.kqed.org/stateofhealth/?p=10370","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/02/05/mammograms-strong-evidence-that-every-two-years-is-best-option-for-older-women/","disqusTitle":"Mammograms: Strong Evidence That Every Two Years Is Best Option For Older Women","path":"/stateofhealth/10370/mammograms-strong-evidence-that-every-two-years-is-best-option-for-older-women","audioUrl":"http://blogs.kqed.org/stateofhealth/files/2013/02/Mammograms-in-Older-Women.mp3","audioDuration":null,"audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_5549\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/05/01/new-research-for-women-in-their-40s-on-mammograms/080922-n-2688m-004/\" rel=\"attachment wp-att-5549\">\u003cimg class=\"size-medium wp-image-5549\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/WomanGetsMammogram_WikimediaCommons-300x203.jpg\" alt=\"(Photo: U.S. Navy)\" width=\"300\" height=\"203\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: U.S. Navy)\u003c/figcaption>\u003c/figure>\n\u003cp>A major new study has found that -- in older women -- mammograms done every two years were as effective as mammograms done annually and led to far fewer false positive results.\u003c/p>\n\u003cp>\u003ca href=\"http://jnci.oxfordjournals.org/content/early/2013/02/01/jnci.djs645.abstract\" target=\"_blank\">The study\u003c/a>, published online Tuesday in the Journal of the National Cancer Institute, included more than 140,000 women ages 66 to 89 from across the country.\u003c/p>\n\u003cp>Frequency of mammograms among women in their 40s and 50s has been the subject of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/05/01/new-research-for-women-in-their-40s-on-mammograms/\" target=\"_blank\">intense debate\u003c/a> for more than two decades, but this older group of women has been much less studied.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The women screened annually had a dramatically higher rate of false positives.\u003c/aside>\n\u003cp>A team led by researchers at UC San Francisco sought to answer the question: among older women, if a woman is screened for breast cancer every two years, instead of every year, will a deadly cancer be missed?\u003c/p>\n\u003cp>\"We found that there really was no difference,\" Dejana Braithwaite, assistant professor of cancer epidemiology at UCSF and part of the research team, told me. \"The women who were screened every two years were not at a greater risk. They did not have a higher probability of being diagnosed with late stage breast cancer compared to those women who were screened every year.\"\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In addition, the women screened annually had a dramatically higher rate of false positives; they were called back for unnecessary mammograms or biopsies. In the study, nearly half of women screened annually -- 48 percent -- had a false positive over a 10-year period, versus about 29 percent of women screened every two years.\u003c/p>\n\u003cp>\"The overall message is that the probability of false positive results is much greater with annual screening and yet there is no added benefit,\" Braithwaite said.\u003c/p>\n\u003cp>The U.S. Preventive Services Task Force created a firestorm of controversy in 2009 when it said women ages 50 to 74 should be screened every two years instead of annually. At that time,\u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm\" target=\"_blank\"> the task force said that\u003c/a> \"the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older.\" Braithwaite says today's study is one step toward advancing the evidence.\u003c/p>\n\u003cp>\"It doesn't mean to say that women in (their) 70s and even in their 80s should not be screened. Indeed, if they are in good health -- women in their 70s -- there is not reason for them not to be screened.\" But if they have other health issues, breast cancer screening could end up causing unnecessary harms.\u003c/p>\n\u003cp>\"So there's a lot of uncertainty about the value of screening in these older age groups, and that's why we're trying to address is this gap of information in evidence,\" Braithwaite said.\u003c/p>\n\u003cp>And as the population ages, it's becoming an \"increasingly important question,\" she concluded.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to the story\u003c/strong>:\u003cbr>\n\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"audio","attributes":{"named":{"label":":http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/Mammograms-in-Older-Women.mp3"},"numeric":[":http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/02/Mammograms-in-Older-Women.mp3"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/10370/mammograms-strong-evidence-that-every-two-years-is-best-option-for-older-women","authors":["240"],"categories":["stateofhealth_12","stateofhealth_13"],"tags":["stateofhealth_176","stateofhealth_235","stateofhealth_86"],"featImg":"stateofhealth_5549","label":"stateofhealth"},"stateofhealth_4769":{"type":"posts","id":"stateofhealth_4769","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"4769","score":null,"sort":[1333667420000]},"guestAuthors":[],"slug":"please-dont-call-it-rationing","title":"Please, Don't Call It Rationing","publishDate":1333667420,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cstrong>New Campaign Urges Doctors to Avoid Unnecessary Tests\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_4778\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/MRI_Machine_JustUs3_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-4778\" title=\"MRI_Machine_JustUs3_Flickr\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/MRI_Machine_JustUs3_Flickr-300x230.jpg\" alt=\"\" width=\"300\" height=\"230\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Just Us 3: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>To many patients, it may seem unbelievable that their doctors would recommend something that is completely unnecessary. But by \u003ca title=\"http://www.rand.org/pubs/research_briefs/RB4522/index1.html\" href=\"http://www.rand.org/pubs/research_briefs/RB4522/index1.html\" target=\"_blank\">some estimates\u003c/a>, that's exactly what happens a third of the time.\u003c/p>\n\u003cp>Yesterday a broad coalition of medical specialty groups -- including cardiologists and family practitioners -- as well as \u003ca title=\"http://web.consumerreports.org/test/SEM/version5.htm?EXTKEY=SG72CR0&CMP=KNC-CROBRANDG&HBX_OU=50&HBX_PK=consumer_reports\" href=\"http://web.consumerreports.org/test/SEM/version5.htm?EXTKEY=SG72CR0&CMP=KNC-CROBRANDG&HBX_OU=50&HBX_PK=consumer_reports\" target=\"_blank\">Consumer Reports\u003c/a> announced a new campaign, \u003ca title=\"http://choosingwisely.org/\" href=\"http://choosingwisely.org/\" target=\"_blank\">Choosing Wisely\u003c/a>. It's a list of 45 tests and procedures that doctors should do much less often for one simple reason: the items on the list are unlikely to be of benefit to the patient.\u003c/p>\n\u003cp>The idea immediately raised questions of rationing and that's exactly where \u003ca title=\"http://www.kqed.org/a/forum/R201204050900\" href=\"http://www.kqed.org/a/forum/R201204050900\" target=\"_blank\">KQED's Forum\u003c/a> started off this morning in discussing the new campaign. UCSF's \u003ca title=\"http://profiles.ucsf.edu/ProfileDetails.aspx?Person=4577990\" href=\"http://profiles.ucsf.edu/ProfileDetails.aspx?Person=4577990\" target=\"_blank\">Dr. Catherine Lucey\u003c/a>, who helped to spearhead the Choosing Wisely campaign, swatted that misconception away.\u003c/p>\n\u003cp>\"It's not rationing,\" she explained. \"Rationing of health care is when you deny needed care to patients. ... Rationing of health care means patients could get better being given a particular drug of subject to a particular test. This is about tests that in many circumstances do not improve quality of life, do not improve quantity of life and potentially could harm patients.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Among the 45 tests and procedures the campaign says to \"question\" are: annual EKGs for patients at low risk of heart disease; MRIs for back pain; and antibiotics for mild-to-moderate sinusitis. The operative word here is \"question.\" Some callers to Forum worried insurance companies would use this information to deny payment, depriving those who might need the test or procedure of something that would be helpful. But Dr. Lucey explained that this is a campaign that was developed by physicians. She said insurance companies had not been involved in the process at all.\u003c/p>\n\u003cp>\"This is not about denying these tests. This is not saying that these tests don't make a difference for some patients,\" Dr. Lucey said. \"It's saying many times they don't. For instance, nuclear cardiologists said 45 percent of routine screening cardiac procedures, stress tests using nuclear radiology, are done for people who don't benefit from those tests, so why do them?\"\u003c/p>\n\u003cp>It was about this time that Forum welcomed \u003ca title=\"http://www.consumerreports.org/health/health-experts/index.htm\" href=\"http://www.consumerreports.org/health/health-experts/index.htm\" target=\"_blank\">Dr. John Santa\u003c/a> to the program. He's director of the \u003ca title=\"http://www.consumerreports.org/health/home.htm\" href=\"http://www.consumerreports.org/health/home.htm\" target=\"_blank\">Health Ratings Center\u003c/a> of Consumer Reports which partnered with the doctor's groups in developing this campaign. (Note: Consumer Reports is generally not a group I associate with supporting rationing).\u003c/p>\n\u003cp>At the heart of the Choosing Wisely campaign is an acknowledgment that patients and doctors need to share in the \u003ca title=\"http://informedmedicaldecisions.org/\" href=\"http://informedmedicaldecisions.org/\" target=\"_blank\">decision making\u003c/a> about a patient's treatment. If a patient wants a test or treatment that is unlikely to benefit them, the doctor needs to explain that. Conversely, if your doctor recommends something to you, you should ask questions. As Dr. Santa noted, Consumer Reports has 75 years of history telling consumers about virtually every industry, including what products work well and what products don't. Now, they find the same desire for information in health care.\u003c/p>\n\u003cp>\"Our surveys of consumers overwhelmingly say they want to have\u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" href=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" target=\"_blank\"> those kinds of conversations\u003c/a>,\" Santa explained. \"They are more and more concerned about cost. They're concerned about safety.\"\u003c/p>\n\u003cp>But this is where I need to digress from \u003cem>Forum\u003c/em> (although I think the entire show is worth a listen; the embedded player is below). I fully support avoiding treatments that are not going to benefit a patient. I also support the concept of shared decision making. The problem is that patients, in general, have so much less knowledge and expertise than doctors.\u003c/p>\n\u003cp>And this brings me to the story of my good friend Saskia van Dijl, someone who is both smart and forceful. She recently developed a severe kidney infection and was hospitalized at a well-respected Bay Area hospital. When I visited her in the middle of her three day stay -- a Saturday -- she looked awful. She was receiving IV antibiotics. And she was concerned. While her doctor had not told her directly, the nurses told her they had found an order for a \"PICC\" line -- a peripherally inserted central catheter. It would be inserted in Saskia's arm, to access a major vein for administration of drugs, like the antibiotics Saskia was receiving.\u003c/p>\n\u003cp>But PICC lines are prone to infection, and Saskia knew that. She wanted to switch to oral antibiotics when she went home. When the doctor came later, Saskia was clear with her doctor. \"I asked point blank,\" she told me. \"'Are you absolutely sure there's not an oral antibiotic that would be as effective?' ... I asked that question three times in three different ways. Lisa, I can't even tell you, I really did not want the PICC line. I felt like it was way too much.\" But the doctor was clear. Saskia got the PICC line -- and had to stay in the hospital another night.\u003c/p>\n\u003cp>The next day, a new doctor was on duty. She took another look and saw a new option, based on Saskia's bacterial culture. There \u003cem>was \u003c/em>an oral antibiotic that could work for her. Saskia asked if the first doctor could have known this, and the answer was 'yes.' Within twenty minutes the PICC line was out, and Saskia went home with oral antibiotics. She has recovered fully.\u003c/p>\n\u003cp>Add the cost of Saskia's PICC line to that one-third of unnecessary health care in this country.\u003c/p>\n\u003cp>I caught up with Dr. Lucey after \u003cem>Forum\u003c/em> and told her Saskia's story. She said when a patient pushes back as strongly as Saskia had, it should prompt the doctor to take a second look at the options. \"Stop, let's re-think this,\" she said. Of course, Saskia could have demanded a second opinion. But by the time the first doctor got back to her, it was Sunday--not a great day for looking for doctors for second opinions. It's also hard to rebut a doctor who is telling you \"this is your only option\" when you're quite sick and lying in a hospital bed.\u003c/p>\n\u003cp>I've watched the discussion back and forth for years. Patients say doctors never explained all the risks. Doctors say, \"Patients walk into my office and demand all these tests.\" The \u003cem>Choosing Wisely\u003c/em> campaign which explicitly acknowledges doctors' role in overtreatment is a step forward. Still, if groups of specialists could come up with 45 tests that are generally unnecessary, one might wonder why they didn't come up with the list a long time ago.\u003c/p>\n\u003cp>Dr. Lucey told \u003cem>Forum\u003c/em> listeners, \"Like any other individuals, sometimes we fall into habits. And this campaign is suggesting we need to critically evaluate those habits.\"\u003c/p>\n\u003cp>Hundreds of billions of dollars could be saved if those habits are changed.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Listen to Forum:\u003cbr>\n\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201204050900.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201204050900.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n","blocks":[],"excerpt":"To many patients, it may seem unbelievable that their doctors would recommend something that is completely unnecessary. But by some estimates, that's exactly what happens a third of the time.\r\n\r\nYesterday a broad coalition of medical specialty groups -- including cardiologists and family practitioners -- as well as Consumer Reports announced a new campaign, Choosing Wisely. It's a list of 45 tests and procedures that doctors should do much less often for one simple reason: the items on the list are unlikely to be of benefit to the patient.\r\n\r\nThe idea immediately raised questions of rationing and that's exactly where KQED's Forum started off this morning in discussing the new campaign. UCSF's Dr. Catherine Lucey, who helped to spearhead the Choosing Wisely campaign, swatted that misconception away.","status":"publish","parent":0,"modified":1335045440,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":23,"wordCount":1143},"headData":{"title":"Please, Don't Call It Rationing | KQED","description":"To many patients, it may seem unbelievable that their doctors would recommend something that is completely unnecessary. But by some estimates, that's exactly what happens a third of the time.\r\n\r\nYesterday a broad coalition of medical specialty groups -- including cardiologists and family practitioners -- as well as Consumer Reports announced a new campaign, Choosing Wisely. It's a list of 45 tests and procedures that doctors should do much less often for one simple reason: the items on the list are unlikely to be of benefit to the patient.\r\n\r\nThe idea immediately raised questions of rationing and that's exactly where KQED's Forum started off this morning in discussing the new campaign. UCSF's Dr. Catherine Lucey, who helped to spearhead the Choosing Wisely campaign, swatted that misconception away.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"4769 http://blogs.kqed.org/stateofhealth/?p=4769","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/04/05/please-dont-call-it-rationing/","disqusTitle":"Please, Don't Call It Rationing","path":"/stateofhealth/4769/please-dont-call-it-rationing","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>New Campaign Urges Doctors to Avoid Unnecessary Tests\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_4778\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/MRI_Machine_JustUs3_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-4778\" title=\"MRI_Machine_JustUs3_Flickr\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/MRI_Machine_JustUs3_Flickr-300x230.jpg\" alt=\"\" width=\"300\" height=\"230\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Just Us 3: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>To many patients, it may seem unbelievable that their doctors would recommend something that is completely unnecessary. But by \u003ca title=\"http://www.rand.org/pubs/research_briefs/RB4522/index1.html\" href=\"http://www.rand.org/pubs/research_briefs/RB4522/index1.html\" target=\"_blank\">some estimates\u003c/a>, that's exactly what happens a third of the time.\u003c/p>\n\u003cp>Yesterday a broad coalition of medical specialty groups -- including cardiologists and family practitioners -- as well as \u003ca title=\"http://web.consumerreports.org/test/SEM/version5.htm?EXTKEY=SG72CR0&CMP=KNC-CROBRANDG&HBX_OU=50&HBX_PK=consumer_reports\" href=\"http://web.consumerreports.org/test/SEM/version5.htm?EXTKEY=SG72CR0&CMP=KNC-CROBRANDG&HBX_OU=50&HBX_PK=consumer_reports\" target=\"_blank\">Consumer Reports\u003c/a> announced a new campaign, \u003ca title=\"http://choosingwisely.org/\" href=\"http://choosingwisely.org/\" target=\"_blank\">Choosing Wisely\u003c/a>. It's a list of 45 tests and procedures that doctors should do much less often for one simple reason: the items on the list are unlikely to be of benefit to the patient.\u003c/p>\n\u003cp>The idea immediately raised questions of rationing and that's exactly where \u003ca title=\"http://www.kqed.org/a/forum/R201204050900\" href=\"http://www.kqed.org/a/forum/R201204050900\" target=\"_blank\">KQED's Forum\u003c/a> started off this morning in discussing the new campaign. UCSF's \u003ca title=\"http://profiles.ucsf.edu/ProfileDetails.aspx?Person=4577990\" href=\"http://profiles.ucsf.edu/ProfileDetails.aspx?Person=4577990\" target=\"_blank\">Dr. Catherine Lucey\u003c/a>, who helped to spearhead the Choosing Wisely campaign, swatted that misconception away.\u003c/p>\n\u003cp>\"It's not rationing,\" she explained. \"Rationing of health care is when you deny needed care to patients. ... Rationing of health care means patients could get better being given a particular drug of subject to a particular test. This is about tests that in many circumstances do not improve quality of life, do not improve quantity of life and potentially could harm patients.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Among the 45 tests and procedures the campaign says to \"question\" are: annual EKGs for patients at low risk of heart disease; MRIs for back pain; and antibiotics for mild-to-moderate sinusitis. The operative word here is \"question.\" Some callers to Forum worried insurance companies would use this information to deny payment, depriving those who might need the test or procedure of something that would be helpful. But Dr. Lucey explained that this is a campaign that was developed by physicians. She said insurance companies had not been involved in the process at all.\u003c/p>\n\u003cp>\"This is not about denying these tests. This is not saying that these tests don't make a difference for some patients,\" Dr. Lucey said. \"It's saying many times they don't. For instance, nuclear cardiologists said 45 percent of routine screening cardiac procedures, stress tests using nuclear radiology, are done for people who don't benefit from those tests, so why do them?\"\u003c/p>\n\u003cp>It was about this time that Forum welcomed \u003ca title=\"http://www.consumerreports.org/health/health-experts/index.htm\" href=\"http://www.consumerreports.org/health/health-experts/index.htm\" target=\"_blank\">Dr. John Santa\u003c/a> to the program. He's director of the \u003ca title=\"http://www.consumerreports.org/health/home.htm\" href=\"http://www.consumerreports.org/health/home.htm\" target=\"_blank\">Health Ratings Center\u003c/a> of Consumer Reports which partnered with the doctor's groups in developing this campaign. (Note: Consumer Reports is generally not a group I associate with supporting rationing).\u003c/p>\n\u003cp>At the heart of the Choosing Wisely campaign is an acknowledgment that patients and doctors need to share in the \u003ca title=\"http://informedmedicaldecisions.org/\" href=\"http://informedmedicaldecisions.org/\" target=\"_blank\">decision making\u003c/a> about a patient's treatment. If a patient wants a test or treatment that is unlikely to benefit them, the doctor needs to explain that. Conversely, if your doctor recommends something to you, you should ask questions. As Dr. Santa noted, Consumer Reports has 75 years of history telling consumers about virtually every industry, including what products work well and what products don't. Now, they find the same desire for information in health care.\u003c/p>\n\u003cp>\"Our surveys of consumers overwhelmingly say they want to have\u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" href=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" target=\"_blank\"> those kinds of conversations\u003c/a>,\" Santa explained. \"They are more and more concerned about cost. They're concerned about safety.\"\u003c/p>\n\u003cp>But this is where I need to digress from \u003cem>Forum\u003c/em> (although I think the entire show is worth a listen; the embedded player is below). I fully support avoiding treatments that are not going to benefit a patient. I also support the concept of shared decision making. The problem is that patients, in general, have so much less knowledge and expertise than doctors.\u003c/p>\n\u003cp>And this brings me to the story of my good friend Saskia van Dijl, someone who is both smart and forceful. She recently developed a severe kidney infection and was hospitalized at a well-respected Bay Area hospital. When I visited her in the middle of her three day stay -- a Saturday -- she looked awful. She was receiving IV antibiotics. And she was concerned. While her doctor had not told her directly, the nurses told her they had found an order for a \"PICC\" line -- a peripherally inserted central catheter. It would be inserted in Saskia's arm, to access a major vein for administration of drugs, like the antibiotics Saskia was receiving.\u003c/p>\n\u003cp>But PICC lines are prone to infection, and Saskia knew that. She wanted to switch to oral antibiotics when she went home. When the doctor came later, Saskia was clear with her doctor. \"I asked point blank,\" she told me. \"'Are you absolutely sure there's not an oral antibiotic that would be as effective?' ... I asked that question three times in three different ways. Lisa, I can't even tell you, I really did not want the PICC line. I felt like it was way too much.\" But the doctor was clear. Saskia got the PICC line -- and had to stay in the hospital another night.\u003c/p>\n\u003cp>The next day, a new doctor was on duty. She took another look and saw a new option, based on Saskia's bacterial culture. There \u003cem>was \u003c/em>an oral antibiotic that could work for her. Saskia asked if the first doctor could have known this, and the answer was 'yes.' Within twenty minutes the PICC line was out, and Saskia went home with oral antibiotics. She has recovered fully.\u003c/p>\n\u003cp>Add the cost of Saskia's PICC line to that one-third of unnecessary health care in this country.\u003c/p>\n\u003cp>I caught up with Dr. Lucey after \u003cem>Forum\u003c/em> and told her Saskia's story. She said when a patient pushes back as strongly as Saskia had, it should prompt the doctor to take a second look at the options. \"Stop, let's re-think this,\" she said. Of course, Saskia could have demanded a second opinion. But by the time the first doctor got back to her, it was Sunday--not a great day for looking for doctors for second opinions. It's also hard to rebut a doctor who is telling you \"this is your only option\" when you're quite sick and lying in a hospital bed.\u003c/p>\n\u003cp>I've watched the discussion back and forth for years. Patients say doctors never explained all the risks. Doctors say, \"Patients walk into my office and demand all these tests.\" The \u003cem>Choosing Wisely\u003c/em> campaign which explicitly acknowledges doctors' role in overtreatment is a step forward. Still, if groups of specialists could come up with 45 tests that are generally unnecessary, one might wonder why they didn't come up with the list a long time ago.\u003c/p>\n\u003cp>Dr. Lucey told \u003cem>Forum\u003c/em> listeners, \"Like any other individuals, sometimes we fall into habits. And this campaign is suggesting we need to critically evaluate those habits.\"\u003c/p>\n\u003cp>Hundreds of billions of dollars could be saved if those habits are changed.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Listen to Forum:\u003cbr>\n\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201204050900.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201204050900.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/4769/please-dont-call-it-rationing","authors":["240"],"categories":["stateofhealth_14"],"tags":["stateofhealth_235","stateofhealth_236","stateofhealth_86"],"featImg":"stateofhealth_4778","label":"stateofhealth"},"stateofhealth_1219":{"type":"posts","id":"stateofhealth_1219","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"1219","score":null,"sort":[1323811684000]},"guestAuthors":[],"slug":"should-older-adults-be-screened-for-cancer","title":"Should Older Adults be Screened for Cancer?","publishDate":1323811684,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_1314\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Grandparents_JasonDeRusha_Flickr_12132011.jpg\">\u003cimg class=\"size-medium wp-image-1314\" title=\"(Jason DeRusha: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Grandparents_JasonDeRusha_Flickr_12132011-300x200.jpg\" alt=\"(Jason DeRusha: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Jason DeRusha: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Right about now, you might be thinking you've heard enough of cancer screening. From mammography to prostate cancer, cancer screening tests have been much debated this fall. \u003ca title=\"http://www.npr.org/templates/story/story.php?storyId=120493002\" href=\"http://www.npr.org/templates/story/story.php?storyId=120493002\" target=\"_blank\">Should a 40 year old woman get a mammogram or not\u003c/a>? \u003ca title=\"http://www.npr.org/blogs/health/2011/10/07/141148384/influential-panel-giving-thumbs-down-to-prostate-blood-test\" href=\"http://www.npr.org/blogs/health/2011/10/07/141148384/influential-panel-giving-thumbs-down-to-prostate-blood-test\" target=\"_blank\">Should men abandon the PSA test\u003c/a>? Yet another study released this week looks at a surprisingly unexplored group--older Americans.\u003c/p>\n\u003cp>Researchers wanted to look at this group because of an \"ambiguity of recommendations\" for them. While it seems like there's some ambiguity for the rest of us, the ambiguity here is particularly surprising since age is perhaps the most significant risk factor for many cancers.\u003c/p>\n\u003cp>\u003c!--more-->The study, \"\u003ca href=\"http://archinte.ama-assn.org/cgi/content/short/171/22/2031\" target=\"_blank\">Prevalence of Cancer Screening in Older, Racially Diverse Adults\u003c/a>\u003cem>,\u003c/em>\" appears in the Archives of Internal Medicine and found that, among adults aged 75 to 79, the screening rates for colorectal, breast, cervical and prostate cancer were between 56 and 62 percent. Screening rates are lower for older adults who are not white.\u003c/p>\n\u003cp>But are these rates good or bad? Too high or too low? The major organizations that issue guidelines on screening are divided on age cutoffs, as are many doctors. \u003ca title=\"http://geriatrics.medicine.ucsf.edu/facstaff/walter.html\" href=\"http://geriatrics.medicine.ucsf.edu/facstaff/walter.html\" target=\"_blank\">Dr. Louise Walter of UC San Francisco's Division of Geriatrics\u003c/a>, captures that divide in a commentary that accompanies the published study:\u003c/p>\n\u003cblockquote>\u003cp>\"Some had advocated for high breast and colorectal cancer screening rates in healthy older adults because the incidence and mortality of these cancers increase with age. ... Others have advocated for low cancer screening rates in persons older than 75 years because the benefit of continuing screening is uncertain and screening can cause substantial harm, especially in frail, older adults.\"\u003c/p>\u003c/blockquote>\n\u003cp>In an interview, Walter spoke of experiences from her own practice. \"I have 80-year-olds hiking in mountains ... and likely to live a long time, and I have people who have serious medical issues, dementia and life limiting disease.\" The types of preventive care she would recommend for these two patients, she says, is very different and not based on age, but on their overall health status.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The study also found that nearly one in ten patients with terminal cancer still received screening tests for breast, cervical or prostate cancer. Walter described cases of older women who have had a hysterectomy, including removal of the cervix, yet still receive Pap smears to test for cervical cancer.\u003c/p>\n\u003cp>\"The thing I try to emphasis is let's do thoughtful cancer screening. Let's avoid cancer screening in someone without a cervix, someone who is in a nursing home, very frail.\" While people often think of screening tests as fairly benign, a positive result can lead to more and more invasive procedures to confirm a diagnosis, invasive procedures that can be very difficult for frail patients to withstand.\u003c/p>\n\u003cp>This study underscores the need for \u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" href=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" target=\"_blank\">doctors to talk with older patients about their overall prognosis.\u003c/a> Walter pointed out that screening tests can become a \"distraction\" from someone's overall health concerns. \"If you had a recent heart attack, that's your major problem. Any major problem should make you rethink, 'Why am I looking for an asymptomatic problem that I probably don't have?'\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"From mammography to prostate cancer, cancer screening tests have been much debated this fall. Yet another study released this week looks at a surprisingly unexplored group--older Americans. Researchers wanted to look at this group because of an \"ambiguity of recommendations\" for them. This ambiguity is surprising since age is perhaps the most significant risk factor for many cancers.","status":"publish","parent":0,"modified":1371247149,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":11,"wordCount":529},"headData":{"title":"Should Older Adults be Screened for Cancer? | KQED","description":"From mammography to prostate cancer, cancer screening tests have been much debated this fall. Yet another study released this week looks at a surprisingly unexplored group--older Americans. Researchers wanted to look at this group because of an "ambiguity of recommendations" for them. This ambiguity is surprising since age is perhaps the most significant risk factor for many cancers.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"1219 http://blogs.kqed.org/stateofhealth/?p=1219","disqusUrl":"https://ww2.kqed.org/stateofhealth/2011/12/13/should-older-adults-be-screened-for-cancer/","disqusTitle":"Should Older Adults be Screened for Cancer?","path":"/stateofhealth/1219/should-older-adults-be-screened-for-cancer","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_1314\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Grandparents_JasonDeRusha_Flickr_12132011.jpg\">\u003cimg class=\"size-medium wp-image-1314\" title=\"(Jason DeRusha: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2011/12/Grandparents_JasonDeRusha_Flickr_12132011-300x200.jpg\" alt=\"(Jason DeRusha: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Jason DeRusha: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Right about now, you might be thinking you've heard enough of cancer screening. From mammography to prostate cancer, cancer screening tests have been much debated this fall. \u003ca title=\"http://www.npr.org/templates/story/story.php?storyId=120493002\" href=\"http://www.npr.org/templates/story/story.php?storyId=120493002\" target=\"_blank\">Should a 40 year old woman get a mammogram or not\u003c/a>? \u003ca title=\"http://www.npr.org/blogs/health/2011/10/07/141148384/influential-panel-giving-thumbs-down-to-prostate-blood-test\" href=\"http://www.npr.org/blogs/health/2011/10/07/141148384/influential-panel-giving-thumbs-down-to-prostate-blood-test\" target=\"_blank\">Should men abandon the PSA test\u003c/a>? Yet another study released this week looks at a surprisingly unexplored group--older Americans.\u003c/p>\n\u003cp>Researchers wanted to look at this group because of an \"ambiguity of recommendations\" for them. While it seems like there's some ambiguity for the rest of us, the ambiguity here is particularly surprising since age is perhaps the most significant risk factor for many cancers.\u003c/p>\n\u003cp>\u003c!--more-->The study, \"\u003ca href=\"http://archinte.ama-assn.org/cgi/content/short/171/22/2031\" target=\"_blank\">Prevalence of Cancer Screening in Older, Racially Diverse Adults\u003c/a>\u003cem>,\u003c/em>\" appears in the Archives of Internal Medicine and found that, among adults aged 75 to 79, the screening rates for colorectal, breast, cervical and prostate cancer were between 56 and 62 percent. Screening rates are lower for older adults who are not white.\u003c/p>\n\u003cp>But are these rates good or bad? Too high or too low? The major organizations that issue guidelines on screening are divided on age cutoffs, as are many doctors. \u003ca title=\"http://geriatrics.medicine.ucsf.edu/facstaff/walter.html\" href=\"http://geriatrics.medicine.ucsf.edu/facstaff/walter.html\" target=\"_blank\">Dr. Louise Walter of UC San Francisco's Division of Geriatrics\u003c/a>, captures that divide in a commentary that accompanies the published study:\u003c/p>\n\u003cblockquote>\u003cp>\"Some had advocated for high breast and colorectal cancer screening rates in healthy older adults because the incidence and mortality of these cancers increase with age. ... Others have advocated for low cancer screening rates in persons older than 75 years because the benefit of continuing screening is uncertain and screening can cause substantial harm, especially in frail, older adults.\"\u003c/p>\u003c/blockquote>\n\u003cp>In an interview, Walter spoke of experiences from her own practice. \"I have 80-year-olds hiking in mountains ... and likely to live a long time, and I have people who have serious medical issues, dementia and life limiting disease.\" The types of preventive care she would recommend for these two patients, she says, is very different and not based on age, but on their overall health status.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The study also found that nearly one in ten patients with terminal cancer still received screening tests for breast, cervical or prostate cancer. Walter described cases of older women who have had a hysterectomy, including removal of the cervix, yet still receive Pap smears to test for cervical cancer.\u003c/p>\n\u003cp>\"The thing I try to emphasis is let's do thoughtful cancer screening. Let's avoid cancer screening in someone without a cervix, someone who is in a nursing home, very frail.\" While people often think of screening tests as fairly benign, a positive result can lead to more and more invasive procedures to confirm a diagnosis, invasive procedures that can be very difficult for frail patients to withstand.\u003c/p>\n\u003cp>This study underscores the need for \u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" href=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" target=\"_blank\">doctors to talk with older patients about their overall prognosis.\u003c/a> Walter pointed out that screening tests can become a \"distraction\" from someone's overall health concerns. \"If you had a recent heart attack, that's your major problem. Any major problem should make you rethink, 'Why am I looking for an asymptomatic problem that I probably don't have?'\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/1219/should-older-adults-be-screened-for-cancer","authors":["240"],"categories":["stateofhealth_12","stateofhealth_13"],"tags":["stateofhealth_82","stateofhealth_86"],"label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg","imageAlt":"On Our Watch from NPR and KQED","officialWebsiteLink":"/podcasts/onourwatch","meta":{"site":"news","source":"kqed","order":"1"},"link":"/podcasts/onourwatch","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1567098962","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw","npr":"https://rpb3r.app.goo.gl/onourwatch","spotify":"https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x","tuneIn":"https://tunein.com/radio/On-Our-Watch-p1436229/","stitcher":"https://www.stitcher.com/show/on-our-watch","rss":"https://feeds.npr.org/510360/podcast.xml"}},"on-the-media":{"id":"on-the-media","title":"On The Media","info":"Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. 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