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Breast cancer

More spending on breast cancer screening doesn't improve detection rates

Thursday, January 17, 2013 by: David Gutierrez, staff writer
Tags: breast cancer, detection, spending

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(NaturalNews) New and expensive breast cancer screening techniques do not appear to provide greater health benefits to women than older, less expensive techniques, according to a study conducted by researchers from the Yale School of Medicine and published in the journal JAMA Internal Medicine.

The researchers calculated spending on breast cancer screening and treatment in 137,274 female Medicare beneficiaries who had not been diagnosed with breast cancer by 2006. All participants were followed for two years, during which time their breast cancer screening, incidence and costs were recorded.

The researchers found that Medicare spends just over $1 billion per year on screening for breast cancer, nearly equaling the $1.36 billion that it spends on treating the disease. According to lead researcher Cary Gross, the researchers had not expected screening costs to be nearly so high.

"It should be a call to do further research to identify the best screening strategy," Gross said. "If we're spending more, does it really help the patients?"

The researchers also found that the amount of money that Medicare spends on breast cancer screening varied dramatically by region of the country, ranging from $40 to $110 per beneficiary. The bulk of the difference was accounted for by differing use of newer and more expensive screening techniques.

"You could argue when it comes to screening, that if you invest more in screening, maybe you'll spend less in treatment," Gross said. "But we didn't find that."

"There was no evidence that higher expenditures were benefiting women living in the high-cost regions," Gross said. "Specifically, there was no relation between screening expenditures and the detection of advanced cancers."

And although the United States Preventive Services Task Force no longer recommends screening women over the age of 74 for breast cancer, Medicare continues to spend more than $400 million each year screening that population.

Lack of data

In recent years, health professionals have increasingly raised concern over the negative effects of excessive breast cancer screening, from the trauma and unnecessary procedures associated with false positives to the dangers of increased radiation exposure.

"We need further studies to identify which women will benefit from screening, and how to screen effectively and efficiently," said Gross. "In some instances, breast cancer screening can save lives. But no woman wants to undergo testing if it is likely to cause more harm than good, and no health system - particularly ours - can afford to spend hundreds of millions of dollars on screening programs without evidence to support them."

John Hugg of the Vanderbilt Breast Clinic, who was not involved in the study, said that the problem is not over-screening, but rather that modern screening is too imprecise.

"There are some breast cancers that might not need aggressive treatment, but we unfortunately are currently unable to identify which ones they are," Huff said. "So it's nice to say we might be over-diagnosing or over-treating, but until we have evidence that helps us understand which people those are, it's hard to separate those out as a group. So we're left being a little less targeted."

(Natural News Science)

Sources for this article include:http://www.eurekalert.org/pub_releases/2013-01/yu-cbc010413.php ;http://abcnews.go.com
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