Now that government is paying the health care bills we are hearing a lot about overtreatment. As always, where one stands on it depends upon how one defines it.
Here is what the National Cancer Institute says about mammograms and overtreatment:
Screening mammograms can find cancers and cases of ductal carcinoma in situ (DCIS, a noninvasive tumor in which abnormal cells that may become cancerous build up in the lining of breast ducts) that need to be treated. However, they can also find cancers and cases of DCIS that will never cause symptoms or threaten a woman’s life, leading to “overdiagnosis” of breast cancer. Treatment of these latter cancers and cases of DCIS is not needed and leads to “overtreatment.” Overtreatment exposes women unnecessarily to the adverse effects associated with cancer therapy
Why not leave the harmless DCIS tumors alone?
It turns out that that medicine cannot predict whether any given DCIS tumor will threaten a woman’s life. If saving lives is the objective, the prudent thing is to take them all out.
Or, as the National Cancer Institute says when it is trying to have its cake and eat it too, “Because doctors often cannot distinguish cancers and cases of DCIS that need to be treated from those that do not, they are all treated.”
In other contexts, removing a growth that might threaten someone’s live is called preventive care. When it is breast cancer, the National Cancer Institute apparently considers it overtreatment.
If the objective is to control expenditures, perhaps the DCIS tumors should be ignored until they begin to spread. The best way to ignore them, and to stop spending even more money, would be to stop looking for them in the first place.
Here’s the quiz: Wisdom teeth that are not causing problems are often removed because x-rays indicate that they are in a position to cause possible tooth loss, infection, or gum disease at a later date. Is this overtreatment? Should the practice be banned by government’s intent on enforcing so-called “global budgets” for health care expenditure?