Sense and Sensibility

If you’re a woman who’d like to do what she can to avoid premature death, you have a right to be feeling a little gyped.Within one week, American women were told to reign in two screening procedures that experts had been assuring them could save their lives —– the mammogram and the Pap smear. Both reversals came in the middle of a ferocious health care debate that has bandied about the term “science-driven medicine,” which sounds so efficient until you realize it means weighing your risk of death against the money it may cost to save you.Mammograms, the “gold standard” of breast cancer preventions, are basically no good for women under 50, a government panel indicated last week. Oh, and by the way, you can quit those monthly breast self-exams. Those are useless, too.

The United States Preventative Service Task Force[---the same group that only seven years ago insisted women over 40 get a mammogram every one to two years -- now says the whole ordeal is an exercise in futility.

After all, we're only talking about one cancer death being prevented for every 1,904 women age 40 to 49 that are screened for a decade. Surely, that hardly merits parading all of those women into a mammography booth. A woman might need a biopsy. Imagine the hysteria that would create.

Yes, you heard right. We have a governmental panel suggesting we cut back on screening because of the "anxiety" it might create among women. Can you imagine a governmental task panel worried about male "anxiety?" "Forget the colonoscopy, tough guy. We wouldn't want to give you the willies." That's condescension masquerading as concern.

But here's the problem with dismissing all those nervous nellies under 50; they're the ones most likely to die of cancer. Breast cancer is the leading cause of death in American women ages 34 to 44, reports Breast Cancer Action. Of the estimated 241,000 women in the United States diagnosed with breast cancer in 2007, about 24,000 were women under 45.

Task force members counter that many irregularities are found in younger women's breasts that are benign. That's true. The problem for cancer specialists is that they do not know which ones will sit around and do nothing for 45 years and which ones will kill you. If they could figure that out, a whole bunch of women would be spared the hellish treatment of purging cancer from their system.

Not too many years ago, the medical community was singing the praises of Hormone Replacement Treatment to treat everything from low-sex drive, to depression to urinary incontinence. But by 2002, the National Institutes of Health put the brakes on a large study looking at HRT after discovering that the therapy raises the risk of breast cancer by 26 percent and heart attack by 29 percent. HRT didn't help dementia and increased a woman's chance of stroke.

So what is it today? Fewer mammograms and pap smears. At some point, the medical community needs to consider the lost of confidence it risks when it turns the lives of ordinary Americans inside out [Dash] and then turns them right-side-in again. Nobody enjoys these medical procedures. We undergo them in the hapless belief that somebody wiser than us knows better. When Americans begin to feel jerked around by experts who tell them fish will cure them on Monday, kill them on Wednesday and make no difference on Friday, they’re likely to hit the “mute” button and head straight to McDonald’s.