Sunday, October 14, 2012

Fact check on NY Times Kristof claim that ObamaCare would have saved man from prostate cancer, Task Force this year has recommended against prostate PSA tests for all men.

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10/14/12, "A Possibly Fatal Mistake," NY Times Op-Ed, Nicholas Kristof

"My freshman roommate, Scott Androes, was in a Seattle hospital bed, a victim in part of a broken health care system....What’s at stake in this presidential election is, in part, lives like Scott’s."...

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Ed. note: Mr. Kristof's Harvard roommate, now age 52, is in late stage prostate cancer. Mr. Kristof believes his friend wouldn't be dying if ObamaCare had been around when his friend was becoming ill, and therefore says you should vote for Obama. A national health task force recently said 
no PSA tests (for incipient prostate cancer) whatever should be given to men. Similar studies have come out saying mammograms and pap tests must be cut back (links below) and not begun until more advanced ages. Such task forces or regulators are to be a major part of ObamaCare. This isn't to make a definitive judgement about the friend, but to express alarm that Mr. Kristof advocates something he appears to know nothing about. ObamaCare itself only demands that you buy insurance, pay a tax, or go to jail. It's not likely ObamaCare would give low or no cost prostate tests to young men since the tests are said to be useless and even harmful, and prostate cancer itself is seen as mainly a part of old age (5/21/12, "Task force: PSA tests do more harm than good," CNN.com). Mr. Kristof's friend chose to have a low income, so he might have been one of many who won't be able to afford Obama's insurance plan and will have to pay the lower cost tax instead. 

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5/21/12, "Task force: PSA tests do more harm than good," CNN.com

"The United States Preventive Services Task Force issued their final recommendation on the PSA prostate cancer-screening test Monday, recommending against routine PSA exams for men of any age. The task force says the PSA exam and additional treatments that may follow, like radiation and surgery, result in far more harm than benefit.

Dr. Virginia Moyer, who sits on the task force, cited that only one out of every 1,000 men who are screened would actually benefit from the exam. Instead, most will have to deal with side effects from treatment that can range from incontinence and impotence, to stroke and death.

Your primary care physician shouldn’t routinely offer the exam," said Moyer. "But if a patient brings it up, that doctor has a responsibility to inform them of the potential harms and risk."

New story: Top American Cancer Society doctor weighs in on the announcement

However, the American Urological Association is not changing its stance on the PSA test.  “We at the AUA still recommend the PSA, with its imperfections," said Dr. Chris Amling. "It’s the wrong thing to deny a man if he wants to have this test."

Related: Value of mass prostate cancer screenings questioned

The PSA test measures the amount of prostate-specific antigens in the blood. While the screening detects the presence of prostate cancer, it cannot make the distinction between aggressive, fast moving cancers, and the more common slow growing ones.
“There is no other screening test for prostate cancer. It’s clear that the only way to cure prostate is to detect it early," Amling emphasized.

Related story: Annual prostate cancer test doesn't save lives, study says

According to the American Cancer Society, prostate cancer is the second deadliest cancer among men, and occurs most often in African-American.  But survival rates also are very high. The American Cancer Society finds that 91% of all men with prostate cancer will live for 15 years beyond diagnosis. According to the National Cancer Institute, 70% of prostate cancer deaths occur after age 75.

Dr. Otis Brawley, Chief Medical Officer of the American Cancer Society supports the recommendation of the task force. “People need to realize that science hasn’t given us the answer," said Brawley. "In the past, when we don’t have a scientific answer, and we’ve guessed, we’ve hurt a lot of people."

Related story: Who decides about screenings?

The task force made its draft recommendation publicly available in October 2011, and reviewed nearly 3,000 comments before issuing its final recommendation."

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It's not just prostate tests, women will get fewer mammograms and pap tests. These task forces even say there's "No benefit" for women to examine their breasts for lumps.

"Billions of dollars will be saved." "Mammograms are of greater benefit to older women." (Oops, wrong age group).
11/17/2009, "Panel Urges Mammograms at 50, Not 40," NY Times, G. Kolata 

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"The recommendations, which help shape how doctors practice..." "No benefit to self-exams." Women 50-74 should only get mammograms "every other year," not every year.

11/17/2009, "Report: Mammograms may not be needed until age 50," USA Today, Liz Szabo

"About 17% of breast cancer deaths occurred in women who were diagnosed in their 40s, he said."...

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Fewer Pap tests says task force:

10/19/11, "Task Force Recommends Women Get Fewer Pap Tests," ABC News, M. Conley

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Comments about Kristof article from Free Republic:

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"Ironically, ObamaCare doesn’t solve the problem that moved him (Kristof's friend) to not get health insurance. ObamaCare doesn’t make insurance cheaper or more broadly accessible, it merely mandates you get it, or pay a fine - either way, the individual is now merely being forced to shell out what they already couldn’t afford, or at least think they can’t afford - which Mr. Androes could have already done without ObamaCare, if he’s had the foresight to do so."

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"Not only that. Whose to say that some bureaucratic panel wouldn't tell him to take a hike....
Or
They will allow treatment but it will start six months to a year from now after he is already dead."


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Ed. note: Again, blogger isn't allowing me to post many links. In place of links and when allowed, I include the name of the relevant article in parentheses. Blogger clearly is bothered about the kinds of things I post, so as soon as is practical, I'll find a new location.
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