Experts say it's probably not due to chance.
By Korin Miller, Self
Most doctors will agree that the earlier a person's cancer is caught, the better the potential outcome: With earlier detection, it's more likely that the cancer will be treatable. That’s why it’s such good news that new research has found that a growing number of breast cancers have been detected at an earlier stage since the passage of the Affordable Care Act, aka Obamacare.
[post_ads]The research, which was published in Cancer Epidemiology, used a nationwide cancer database that contains information on 70 percent of all newly diagnosed cancers in the United States. The study’s researchers analyzed breast cancer diagnoses in more than 211,000 women aged 50 to 74 who were diagnosed from 2007 to 2009, i.e., before the ACA went into effect. Those patients were compared with nearly 260,000 diagnoses from 2011 to 2013, when the ACA mandated that women could not be charged a co-payment for having a mammogram and other preventive services.
The researchers found that, after the ACA was implemented, the percent of cancers diagnosed at Stage I (the earliest stage official stage of cancer) increased by more than 3 percent for white women, 4 percent for black women, and more than 4 percent for Latinas. With that said, minority women were still more likely than white women to be diagnosed when their cancers were at later stages.
The percentage increases don’t seem particularly high, but lead study author Abigail Silva, Ph.D., M.P.H., a professor at Loyola University Chicago, tells SELF that this news “translates into a potentially significant public health impact,” given that about 250,000 women in the United States are diagnosed with breast cancer each year. “A small shift toward Stage 1 diagnoses would improve the prognosis for thousands of women,” she says.
Obviously this is just one study, and the researchers point out that more time may be needed to see more results. Also, the researchers can’t definitively say that the ACA produced these results—rather, there was a correlation of women whose breast cancer was detected at earlier stages while the ACA was in effect, Richard Reitherman, M.D., Ph.D., medical director of breast imaging at MemorialCare Breast Center at Orange Coast Memorial Medical Center in Fountain Valley, California, tells SELF. More women were already getting mammograms than in the past prior to the ACA, he says, so things were already on a positive trend.
However, he adds, “I really believe the ACA has brought a lot of people into the screening program, we just don’t know what percent.” The researchers of this latest study agree, concluding that the ACA seems to have had a “meaningful impact” on the stage at which a woman’s cancer is detected and, presumably, survival rates.
Finding cancer early can be a true game-changer.
Early detection is "extremely important for any cancer, and especially breast cancer," Jame Abraham, M.D., F.A.C.P., director of the Breast Oncology Program at Taussig Cancer Institute and co-director of the Breast Cancer Program at Cleveland Clinic, tells SELF. Elyse Lower, M.D., an oncologist and director of the University of Cincinnati Cancer Institute’s Comprehensive Breast Cancer Center, and a professor at the University of Cincinnati College of Medicine, agrees. “Earlier stage disease diagnosis is associated with better outcomes and survival rates,” she tells SELF.[post_ads_2]
Specifically, early detection translates to fewer deaths due to breast cancer, and people with breast cancer needing less extensive surgeries, fewer mastectomies, and less frequent or aggressive chemotherapy, Amy Kerger, D.O., a breast radiologist with The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, tells SELF.
While early detection is generally thought of as a good thing, there has been some controversy recently about women being diagnosed very early with ductal carcinoma in situ, aka “Stage 0” breast cancer, a non-invasive cancer where abnormal cells have been found in the lining of the breast milk duct but have not spread outside of the ducts into the surrounding breast tissue.
Oncologists are mixed on how to treat it. Some say Stage 0 breast cancer needs aggressive treatment, like hormonal medication or a lumpectomy, because it can progress to more advanced stages of cancer. Others choose watchful waiting. Dr. Lower calls Stage 0 breast cancer “a bit of a quandary,” adding, “finding it early in subsets of women is probably not necessary and we probably over-treat it” with methods like invasive surgery that may not be warranted. Dr. Lower says doctors still struggle with how best to handle Stage 0—however, early detection is still better than none.
It’s unclear how a new health care bill would change coverage for preventive services like mammograms.
If you’ve been following the news lately, you’re likely aware that the ACA and its provisions that allow people access to preventive care are in danger. It's true that Congress's attempts to replace the law with the House's American Health Care Act and the Senate's Better Care Reconciliation Act have not been made law. But it's still possible that health care as you know it now will change in the future. One of the most worrisome aspects is that both bills would allow states do away with the Affordable Care Act's mandate to cover essential health benefits, including preventive services. “I see patients every day who are terrified as to what will happen,” Dr. Lower says. “People are nervous.”
[post_ads]That’s why Dr. Kerger says it’s important to act now when it comes to your health. Make sure your lawmakers are aware of what you want by calling, emailing, or writing to them. “Being proactive now so that the health care bill [is more likely to] contain what women want for their health care is the best way to ensure coverage for the future,” she says.
There are also no-cost and low-cost programs through organizations like the Susan G. Komen foundation that can help people pay for mammograms if they’re no longer covered, Dr. Reitherman says. Mammograms can also be more affordable through Planned Parenthood, he says, (although of course, federal funding to clinics that provide abortion services, like Planned Parenthood, may be in jeopardy in the future). States also offer breast cancer screening to low-income, uninsured women through the National Breast and Cervical Cancer Detection Program, Dr. Silva says.
No matter what happens with the state of health care, Dr. Lower says it’s also important that you’re aware of your personal risk of breast cancer. For example, having a family history of the disease increases your risk, as does smoking. If you’re at an increased risk, she recommends flagging it for your primary care physician, who can recommend next steps. Here's what you can do to lower your breast cancer risk.
Unfortunately, it’s possible to get breast cancer even without a family history or other risk factors, Dr. Lower says, which is why she urges women to get regular mammograms once they hit a certain age. (The American Cancer Society recommends that women of an average breast cancer risk aged 45 to 54 get mammograms every year, then have them every other year from 55 onward.)
Many doctors also recommend breast self-exams, even though most breast-health organizations have moved away from officially promoting them because there's not enough clear research-based evidence that the practice offers more benefits, like early detection, than harms, like unnecessary testing or emotional stress. Still, doctors advise generally staying aware enough of your breasts to notice any changes that you would need to bring to the attention of a medical professional.
Ultimately, Dr. Lower stresses that early detection saves lives: “Women need to know that we’re all at risk and we have to take action to make sure we get screened appropriately."
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