Three days ago, on November 22, 2012, an article was published in the New England Journal of Medicine questioning the utility of mammogram screening for prevention of death from breast cancer. The authors were research professor Archie Bleyer MD at Oregon Health and Sciences University in Portland, an oncologist who was chief of pediatrics at MD Anderson Cancer Center and H. Gilbert Welch MD, MPH, a professor at Dartmouth Medical School. The article examines the ability of mammograms to prevent late stage breast cancer by diagnosing and treating breast cancer early as a result of detection by mammograms. They found that mammograms do detect lots of breast cancer, but when we compare women during the years 2006-2008 when mammogram screening was widely practiced to women during the years 1976-1978, there was no difference in the incidence of the really nasty breast cancers, ones that had spread beyond the regional lymph nodes, and only a small decrease in the less nasty...
The cost of health care in the US is higher than anywhere else in the world, and yet we are not healthier than our peer nations. In fact, in terms of such measures as infant mortality and life span, we don't measure up. Why is this? Many people involved in providing or receiving care have some pretty good ideas about what costs so much, and what we can do to reduce costs and improve quality. Sharing these stories is an important step in creating affordable universal health care.