Could you elaborate on the reasoning behind this, given that a CT scan is the equivalent of about 250-400 chest x-rays - if you don’t have lung cancer already, we’ll give it to you? :eek:
Not saying this is the case in your family, but you’ve got me wondering about all the false positives giving people a “family history of breast cancer” - since people don’t know if they were the ones who had a non-critical lump removed, now you have a history of breast cancer and a family history of breast cancer which might not have been warranted. This would also contribute to people thinking they need these screening tests.
I’m on the fence about mammography for myself - I’ve had my mammograms, and they return false positives for me because of cysts. That’s my family history - no breast cancer, but lots of cysts!
First I’d heard about this, and I’ve gotten my PSA level checked regularly. PCP sent me to a specialist about it one year when it bounced up a bit, too. Next time I get my PSA levels checked, I’ll be sure to ask about this.
45, and I get annual mammograms. I’m of an ethnicity at higher risk for breast cancer, and a Pap quite probably saved my life ~ 10 years ago, so I am a believer in recommended screenings. I wouldn’t go nuts if I missed a year, though.
One thing that strikes me about these two particular screenings being quite controversial as to their effectiveness, I’d think someone somewhere would be doing a lot of research to try to get better specificity with these tests. For example, a PSA test where you get a high result, but not to worry, because its the slow-growing, non-invasive type of cancer that will take longer than you have to live to kill you. And maybe they are; just finding questionable results and taking everyone’s prostate out (or breasts off) doesn’t seem good enough to me.
After a rapid increase in PSA (15), I had a biopsy. They graded the cancer with a 3 x 7 on the Gleason score. The urologist said, Don’t worry, I have a knife". The oncologist said, “Don’t worry, I have radiation”. I didn’t like the risks involved with either of these procedures. I saw a NP. He recommended we send the biopsy slides to a different lab and have them read by prostate professionals. They scored a 3 x 3. Although only a point difference, the scale is exponential and it made a huge difference in my decision to not have surgery or radiation. I take herbs and a prescription drug. After five years my PSA is 3.
Another thing that occurs to me is that screening tests with these high false positives are perfect for the abomination that is for-profit healthcare. Everybody gets screened - money. A whole bunch of people get treatments that they don’t need - money.
This bothers me as well. Aside from mammograms the big thing with women is pap smears. I once had a doctor try to give me one when I was a 17 year old menstruating virgin. That’s not one, or two, but THREE very good reasons why I should not be given one. Even if they didn’t believe the virgin part, the age and menstruation are plenty good enough reasons on their own as they throw all the results off. That and no health organization anywhere advocates them that young. Another time when I went to a GP for an ear infection they grilled me on when my last pap was as though it was in any way related. Seriously?
I’ve been on a quest for a doctor that doesn’t hold birth control hostage in the name of more pap smear profit ever since.
Since I have no history of cancer in my family at all I was never planning to get a mammogram either unless actual physical lumps showed up.
As a woman in the recommended age group whose two genetic aunts add up to three breast-cancer survivors, hell yeah I do!
Paternal aunt, in her early 30s and pregnant; cancer found when the nurse showed off the brand-new ultrasound machine. Maternal aunt, mid-40s and late 60s, two unrelated kinds; found during self-exam and during routine oncologic check. Given the degree of advance in all three cases, none sounds like it could be a false negative.
Addendum: I get called by my UHC service every two years for the titsmoosher and every two years for the gyn visit (alternated). The current protocol doesn’t require a follow-up ultrasound due to “OMG cysts!” any more, as those cysts are known (they’ve been with me for so long that if I knew how many they are and where I would have given them names). Since the pics are computerized, they can compare the old ones with the latest batch and determine whether anything looks like it wasn’t already there.
Sorry, I missed your post. (I’ve mostly been reading the board from my phone lately and can only squint for so long.) I appreciate hearing your thoughts.
I just wanted to clarify that I don’t blame my doctor (or any individual doctor) for any of the issues I mentioned in my post. I’m not sure who should get the blame for the disproportionate amount of attention given to breast cancer versus other common cancers, but I’m pretty sure it isn’t individual physicians.
My mention of a chest x-ray for screening was just an attempt to describe an equivalent for a mammogram that was related to my biggest (at that time) health risk, smoking. Far, far more effort was put into convincing me to get an annual mammogram than was ever invested in convincing me to quit smoking.
I certainly can understand that. Still, I think there are better ways to expend our strained health care resources than over-testing, so I hope the new guidelines will be taken seriously.
I have to disagree with you on this. I understand that a PCP is not the doctor who should be diagnosing mental health issues or, except in certain situational cases, treating them. I think a good PCP will refer a patient to proper care if there is suspicion of a psychiatric illness. However, in my case my mental health problems are well known by all my physicians, documented with over 20 years of history in my chart, and discussed at every appointment, because they have a significant effect on my physical health. This discussion only happens because I make it happen, not because any of my health care providers has ever bothered to ask why I’m on such a variety of psychiatric medications. I have to force them to acknowledge this illness and I have to educate them on its effects. I don’t think I should have to do this. My thinking is that many of them have no time to read my chart, but that’s a whole 'nother thread.
I guess what it all comes down to is that I wish they (whoever “they” are) would give me a single reminder about the issues that might someday arise (but probably not) and spend the time dealing with the problems I already face.
I’m 42, and haven’t had a mammogram yet. When my former PCP mentioned it to me about a year ago, I said, “Aren’t there recent conflicting studies about the value of mammograms before 50?” He agreed, and then mentioned that his wife – also a doctor – was 40 and hadn’t had one herself yet. He left it up to me, and for now I don’t see the value. Part of me thinks that I’ll wait until I turn 50, but I’ll probably split the difference and start them when I’m 45.
Although, I think your statement may be more extreme than I’d care to state, I agree that the result of good intentions (the PSA test) is the same as if it had been a profit making conspiracy.Fortunately, PSA tests are no longer recommended annually.
Actually, my concern is the profit center that results from colonoscopies. My mother has a ‘moderate’ rink of colon cancer after the results of her last colonoscopy. But colon cancer is very slow growing, She’s supposed to get a colonoscopy every three years. She’s 90. I’m strongly discouraging this as there is a greater risk to her from the anesthesia than there is from cancer.
I think mammograms are close to a waste, but the VA is fussy about it, so I go.
I’m 45. My father is adopted and I know absolutely nothing about his family medical history. He does, but we’re estranged and he will not tell me. (I only know about the diabetes because he has it and my grandfather - his adopted father - told me my father has it.)
My mom’s family doesn’t have a cancer history - they have blood clotting issues (both too much and not enough).
Given the high false positives I’ve decided to hedge my bets and have it done biannually every year after I turn 50.
If you don’t know what bloodwork your doctor is ordering, you should ask. I don’t do tests without knowing what they are, personally. If your doctor is so arrogant that he doesn’t communicate with the patient, then it’s time to find a new doctor.
You bet your sweet bippy I get my PSA tested. It’s a .24, so low that my doctor doesn’t even bother to do the manual test, for which I am grateful. Better digits on the paper than digits elsewhere IMHO.
It’s very difficult to turn back the clock and rescind a recommendation for tests that were once recommended. We can do all the research and make all kinds of informed decisions, but “better safe than sorry” leads people to do more tests rather than fewer. And that’s talking about us Dopers, who actually will do research and think about these things; we’re not typical medicine consumers.
I’m thinking about that old Herman comic, with a doctor talking to an ancient old man - “Herman, you’re 95 years old; you have to start taking care of yourself.”
I’m 53 and have gotten a PSA test since I was 40. The reason why is my father died at age 66 of prostate cancer. In a digital exam a doctor can only manipulate only 3/5 of the prostate, so if the growth is on 2/5 side it might not be discovered. Perhaps if the PSA was available to him then, he might still be alive.
