Unbiased Analysis of Today's Healthcare Issues
What are the economic consequences of the updated USPSTF recommendations to move the age for annual breast cancer screening to age 40? I was interviewed at NPR’s Marketplace Morning Report today (May 11, 2023) to help answer the question. You can listen to the episode here (the segment on breast cancer screening starts at 5:32).…
Let’s get this out of the way: both are clearly important. Within appropriate screening, patients don’t get the treatment they need. Further, delayed screening can make treatments less effective if the cancer has progressed or metastasized. On the other hand, without effective treatment, screening won’t have a major impact on patient outcomes. The question is,…
The National Cancer Institute (NCI) publishes screeening rates for breast, cervical, and colorectal cancers over the past 25 years. I have reproduced the charts below. I wonder how the USPSTF recommendation in November 2009 that women ages 40 to 49 should not undergo screening unless they are in a high-risk group will affect mammography rates in the most recent…
The answer is ‘no.’ For instance, consider the case where breast cancer screening is subsidized, but you are uninsured an breast cancer treatment is unaffordable. What is the value of breast cancer screening? It is probably pretty low since if you find out you have breast cancer, there is not much you can do about…
The hepatitis C virus (HCV) is largely curable: “In clinical trials, antiviral therapy with pegylated interferon and ribavirin (PEG-IFNR) has resulted in a sustained viral response (SVR) (that is, cure) of HCV infection in 46% of patients infected with genotype 1 (which infects 70% and 90% of chronically infected white and African American persons in…
For many years, the Dartmouth Atlas has chronicled how variation in medical resource use across the country. Despite glaring differences in the cost and volume of care across the nation, regions with higher health care costs do not necessarily have better health outcomes. However, medical treatment is a two step process. First, the physician must…
Does better screening lead to improvements in health outcomes? Conventional wisdom holds that this is always true. For instance, catching breast cancer at an early stage greatly improves survival probabilities. However, early screening can lead to a statistical anomaly where better screening appears to improve mortality rates even when treatments are entirely ineffective. Here is…