Thursday, April 9, 2015

That's a lot of money

There is a lot of talk about breast cancer over diagnosis and false positive mammograms. A new report looked at the costs involved. They are big numbers:

How much does each false positive  mammogram, or IDC or DCIS over diagnosis cost?
  • Mammogram - $852
  • IDC - $51,837
  • DCIS - $12,369

The total is around $4 billion (with a b) each year. That is a lot of money! The breakdown is $2.8 billion resulting from false-positive mammograms and another $1.2 billion attributed to breast cancer overdiagnosis. But its not just the financial cost but the emotional toll on the patient.

"Apart from the financial cost of screening tests and treatment, false positives and overdiagnosis expose women to risks from additional medical procedures, not to mention psychological distress. It's not uncommon for mammograms to turn up some apparent abnormality that has to be resolved with more imaging tests or a biopsy.

"We're hoping that the financial cost of this problem will help cast into greater relief the human cost," said co-author Mandl. "The two messages together are powerful. The fact that this is not only a problem, but a very costly problem, we hope will accelerate the attempts to try to fix the screening practices."

But another expert defended those practices, and called the study one-sided.

"There was no attempt to balance the costs with the benefits," said Richard Wender, who heads prevention, detection and patient-support efforts at the American Cancer Society. "I strongly feel that every study that looks at the downsides of any screening test has to be balanced with the benefits.""

But the benefits? Are those lives saved by screenings? I would hope so. But that is so much money. Maybe we need better diagnostics as well as a cure.  And yesterday's post on mortality vs survivorship numbers - think of how skewed they could be as a result of these errors.

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