A new argument for not participating in health screenings involves a theater analogy. Two researchers, Dr. Andrew Lazris and Erik Rifkin, ask you to imagine a sold-out house of 1,000 playgoers or concertgoers, all getting a particular kind of screening. When the curtain falls, everybody helped by the procedure gets up and leaves. The researchers argue that it’s only a few people—sometimes nobody—who get out of their seats.
They highlight breast exams as an example, asserting that only one woman in the thousand-person theater receiving mammograms over a lifetime is saved from dying by detecting a cancer before it spreads. At the same time, hundreds of women in that audience will receive “false positives,” which, they contend, will potentially lead to unnecessary, costly tests and treatments.
Americans have more responsibility than ever for both the cost and control of their health, yet they are getting confusing guidance about how frequently they should be assessing their health risk. Even the U.S. Preventive Services Task Force has recently called for less frequent screenings–breast cancer among them. But we’re not getting any healthier. One out of every two Americans has a chronic disease.
Since it is October and Breast Cancer Awareness month, let’s pull back the curtain on this disease in particular.
· One in eight women (12%) will develop an invasive form of breast cancer over the course of their lifetime (breastcancer.org). That means, when you go to the theater for real, it is likely that someone in every other row has faced or will face a diagnosis of this devastating disease.
· Studies have shown that mammograms are finding more breast cancers early, when they may be less complicated and less costly to treat.
· One study found that the average 24-month cost of treating breast cancer when diagnosed at stage 4 is nearly double ($182,655) the cost of treating a stage 1 or 2 diagnosis ($97,066).
· Knowledge empowers people to take action and Americans want to know. 71% of insured women get their mammograms. What’s more, 73% of women surveyed believe mammograms should start before age 50 (the current USPSTF guideline) and another 60% of women say every-other-year mammograms are not frequent enough (January HealthMine survey).
· A quick Google search will pull up countless stories of women sharing how a mammogram saved their life. For these women, the potential harms and risks of a mammogram are a hard argument to sell. They pale in comparison to the vivid, life-saving knowledge this test delivered to them.
In absence of a cure or inoculation, early detection is our best weapon against breast cancer and many more diseases that are often first identified by a routine screening. Health plan sponsors, be sure you look behind the curtain and carefully consider all of the data—and the voices of your members—before choosing whether or how aggressively to promote screenings in your population.