Can IT Help New Cancer Screening Guidelines? - InformationWeek

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Government // Leadership
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11/23/2009
01:36 PM
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Can IT Help New Cancer Screening Guidelines?

New recommendations from a federal task force last week about breast cancer screenings have infuriated many cancer survivors as well as medical professional organizations, including the American Cancer Society. The guidelines were based on data analysis of the risks and benefits of mammograms for women under age 50.

New recommendations from a federal task force last week about breast cancer screenings have infuriated many cancer survivors as well as medical professional organizations, including the American Cancer Society. The guidelines were based on data analysis of the risks and benefits of mammograms for women under age 50.Had the task force's findings not come at the exact time Congress and the White House are working on massive and potentially groundbreaking national healthcare reform, the recommendations still would've faced much scorn, but probably significantly less suspicion about the guidelines in any way being motivated as cost-cutting measures to help pay for new government-run healthcare programs.

The timing of the guidelines, which suggest women forgo annual screening mammograms till age 50, spooks a lot of people, including folks who otherwise support healthcare reform, but are now left wondering if the guidelines are indeed a precursor to rationed care.

Nonetheless, the task force says the recommendations are based on data analysis of how often yearly mammograms of younger women catch actual cancers versus false positives that lead to worry, more tests, biopsies--and of course, additional costs.

Any woman who has undergone breast cancer--especially anyone who was under age 50 at time of diagnosis and had her malignancy discovered through regular screening--will tell you emphatically that the research sounds more like bean-counting than advice to save lives. She'll tell you that she'd gladly have gone through a few weeks of anxiety and additional tests with a happy, benign outcome instead of any chance her cancer would've been caught "too late" because she skipped that early screening.

It's probably too soon to predict whether these controversial recommendations will ever seep into formal policy from insurance companies and government programs about how breast cancer tests are covered in health plans.

However, one must hope that before these guidelines ever become new rules, that there will be advanced clinical support tools available to help doctors precisely identify which patients are candidates for earlier screenings, based on what's known about a woman's medical and family history, genomes, and other highly individualized factors.

Already, advances in personalized medicine technology are helping some doctors--including those at Beth Israel Deaconess Medical Center in Boston-- make smarter choices about other radiology tests performed on patients based on their symptoms, previous exposure to radiation, medical history and other factors.

Hopefully, decision support tool vendors and innovative healthcare providers are already anticipating ways they can assist physicians and patients to make the best decisions possible about cancers screenings based on the federal task force findings and other new scientific research as it unfolds.

In the meantime, there are millions of American women and healthcare professionals feeling uneasy, angry and distrustful.

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