As physicians, we continually encourage our patients to undergo regular cancer screening and to pay attention to recommendations about diet and exercise. What if our patients actually listened to us?
The American Cancer Society recently issued recommendations for yearly MRI scans of the breast in addition to mammograms for high-risk women. These $1,000 to $2,000 tests are effective and increase detection of pre-clinical cancers.
However, as one of the co-authors of the report recently described, we currently do not have enough MRI capacity or radiologists to interpret the volume of tests that would be generated by complete compliance with the recommendations.
- Why is screening recommended YEARLY? Cancer doesn’t recognize any calendar. Could studies be directed to better determine the most effective interval?
- How can we address the disparities in cancer screening? Uninsured women already have lower mammography rates compared to all women (37 percent vs. 61 percent). An expensive, resource-intense study will increase this gap.
- How about people with other types of cancer? What studies will determine whether this information can be translated to cancer of other parts of the body?
- What happens when the next big study is released? What if it turns out that PET/CT is eventually proven to be more effective than MRI? That would quadruple the cost.
Early detection saves lives and money. We need to make sure the benefits reach all people.
The following is feedback received from this blog posting:
"How many hours is the MRI UNIT in operation at your facility.? Why not operate it 24/7. Wouldn't that bring the cost of these expensive machines down to the facility and therefore also the test cost to the patient. Maybe we need a certificate of need mandated by the state of Wisconsin to limit the amount of money spent. Its like having three cars in the garage for two people to use. Why is southeastern Wisconsin one of the most expensive medical areas in the U.S."