Newspaper article THE JOURNAL RECORD

Medicine Field Becoming Too Sophisticated for Blanket Rules

Newspaper article THE JOURNAL RECORD

Medicine Field Becoming Too Sophisticated for Blanket Rules

Article excerpt

WASHINGTON -- Every day, frightened middle-age women ask cancer counselor Mary Ann Braun to tally their risks of breast cancer so they can decide whether to get mammograms starting at age 40 or 50.

The women are furious that the government won't simply tell them what to do.

But experts say Americans better get used to making their own choices because medicine is fast becoming too sophisticated for blanket rules. Just as you wouldn't choose a particular surgery merely because your neighbor did, doctors say patients need disease prevention advice -- from cancer tests to healthy-heart guidance -- tailored to their personal habits and genes. "There's a change going on in health care where doctors used to be the ones making the recommendations and you followed the advice," said University of Chicago urologist Dr. Gerald Chodak, who makes men sign a detailed form listing the pros and cons of prostate cancer screening before he will test them. "Gross recommendations for everyone in society is a very crude" approach, agreed Dr. Harmon Eyre of the American Cancer Society. "The more we can individualize these recommendations, the better off we'll be." The question is whether the average layman understands the science enough to decide. "I just wish in my heart I felt every patient I saw really had ... the skills to understand, and access to all that information," said Braun, who as coordinator of Georgetown University's Comprehensive Breast Center teaches women of varying educational levels to weigh their personal cancer risks against mammograms' drawbacks. As doctors learn more about the genetic and other risk factors that determine who gets sick with what, they are expected to replace expensive, one-size-fits-all health rules with tailored advice. But the mammogram uproar underscores just how controversial the change is. A government panel in January said there wasn't scientific proof that regular mammograms in the 40s were beneficial enough to recommend them for all middle-age women. It is generally agreed that women should have annual mammograms from their 50s onward, because studies show the tests cut deaths in older women. …

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