Zorba Paster: Screening Guidelines Can Be Confusing

Guidelines Set By Medicare And Insurance Companies Often Lag Behind Scientific Discovery

By
Phillip Jeffrey (CC-BY)

The battle cry for cancer has been, “Get tested now.” We’ve been saying this mantra for so long we’ve come to believe that if we don’t test, we’re going to miss something — with the assumption that the “something” could be of great importance and give us the key to a longer, sweeter life.

But does it?

We know breast cancer and colon cancer screening for those in their 50s is worthwhile; the data certainly supports that. We know annual chest X-rays for smokers are worthless. We have standard tests to screen for lung cancer, which kills a staggering 150,000 people a year.

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A recent article in the Journal of the American Medical Association’s Oncology publication found that 1 in 7 seniors had unnecessary screenings for prostate and breast cancer. Why?

Guidelines from the U.S. Preventive Services Task Force have argued against screening for these cancers in older Americans because they have not been shown to increase longevity. We assume that if we catch cancer early enough we’re saved. But there are two counterarguments against this.

First is the idea that some cancers are so slow-growing they would never affect a person, so why get treatment? That’s especially true of senior citizens with prostate cancer.

And next, there is the fact that heart disease can strike at any time. So you might be saved from cancer, but heart disease gets you.

This is not an easy black-and-white question. I think it ignites a discussion we need to have with our doctors.

But there is a fly in the ointment. Physicians often are reimbursed based on screening rates. Generally, the more screening you do, the assumption is the better you are. And for the most part, that’s true.

The problem is that the guidelines set by Medicare and insurance companies often lag behind scientific discovery. It takes a while for the guidelines to catch up with the newest data.

To protect yourself, you should ask your doctor whether they think the screening is really necessary. It’s an important individual decision everyone should make with their health care provider after a robust discussion.

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