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0 of 3 Premium Clicks used this month SUBSCRIBE Print + Online Subscriber Activation | Register x Forgot Password | Need an Account? subscribe | newsletter | deals Home News Latest Stories Calendar: Saturday, Oct. 25 Helman students illustrate kindness, love Newly renovated Ashland Hills hosts open house SOU's 'Count Me In' campaign raises $210,000 Aquatics backer announces write-in candidacy for Parks & Rec board Education Helman students illustrate kindness, love SOU's 'Count Me In' campaign raises $210,000 Fun, fundraising and art at Helman Elementary School Ashland mourns death of former coach Stan Gida Goal not reached, but don't count out 'Count Me In' yet Environment Rite Aid cub well, could come back to southern Oregon Report: Smaller streams need further protection Bear cub wanders into Rite Aid Kalmiopsis' future at stake if mining goes forward Fires and forests evolved together, but now people are in the mix Business Newly renovated Ashland Hills hosts open house Hot Stuff Espresso Blue Toba erupts onto dining scene Interim president leads in a different direction Silvio Calabi: Acura’s 2015 TLX is two cars in one Politics and elections Aquatics backer announces write-in candidacy for Parks & Rec board Richardson accuses Kitzhaber of 'corruption' in final debate Stricker steps down from Talent council Merkley-Wehby to debate in Medford Ashland land use rule review continues State News Nation - World Obituaries Ronald J. Hupp Death Notices Gary Wayne Campbell Brian Douglas Bellamy Death Notices Sports Latest Stories They're twins, and they're good Royals' Guthrie to face Giants' Hudson in Game 3 App Finder: Best basketball apps No. 11 SOU volleyball team returns home for two key matches Ashland mourns death of former coach Stan Gida High school They're twins, and they're good Ashland mourns death of former coach Stan Gida What slump? Grizzlies drop-kick Eagles Grizzlies row to raise money for regatta Grizzlies run out of magic in loss to No. 3 Springfield Southern Oregon University No. 11 SOU volleyball team returns home for two key matches Ashland mourns death of former coach Stan Gida SOU football team falls to No. 7 in NAIA rankings No. 4 SOU, No. 3 Carroll to square off in Frontier Conference showdown Third-ranked Concordia strikes quick, topples SOU Opinion Latest Stories Our View: Fix the 'free speech zone' Teaching the First Amendment Granlund cartoon: New York Ebola Jim Brock: Should government legalize gay marriage? Amy Gehrt: Your vote counts this Election Day Editorial Our View: Fix the 'free speech zone' Our View: Cheering Ashland's own Kitzhaber is the better choice Our View: Merkley, with a nudge Our view: Positive about Bates Letters Letters to the Editor, Oct. 24 Letters to the Editor, Oct. 23 Letters to the Editor, Oct. 21 Letters to the Editor, Oct. 21 Letters to the editor Guest opinions Teaching the First Amendment Guest Opinion: Media are part of the pot prohibition problem Wilderness successes could be lost if funding not restored Religion and politics in America City should revise its rules for murals Revels Latest Stories Listings for Varsity Theatre and Ashland Street Cinemas Repertory singers prepare 'powerful' opening concert Griffin heads to Historic Ashland Armory Best Bets Oct. 23-30 'Fury' shows the grim toll of war Theater New plays debut at ANPF Music Repertory singers prepare 'powerful' opening concert Q&A: Broken Down Guitars The Farr Side: Bryan Adams releases album of influential hits Tutunov Piano Series begins at SOU Q&A: Becky Alter Visual Art Ashland's First Friday Art Walk Movies Movie review: ‘Whiplash’ hits high notes Movie review: ‘Birdman,’ Keaton soar Listings for Varsity Theatre and Ashland Street Cinemas 'Fury' shows the grim toll of war Listings for Varsity Theatre and Ashland Street Cinemas Food and Drink Cruelest Month: Poetry Blog Lifestyle Latest Stories Portal to freedom and expanded human potential Frank Talk: A little Halloween humor circa 1970 Barry Lewis: The idiot light Community Blog: Predicting Peace - Part 6 of 7 Dr. Jeff Hersh: Controversy over breast cancer screening Aging Happens Inner Peace Column Inner Peace Blog Classifieds Jobs Autos Real Estate FEATURED » Obituaries Photos Videos Blogs NEWS NOW Calendar: Saturday, Oct. 25 ... Our View: Fix the 'free speech zone' ... Teaching the First Amendment ... Calendar: Saturday, Oct. 25 ... Our View: Fix the 'free speech zone' ... Teaching the First Amendment ... Dr. Jeff Hersh: Controversy over breast cancer screening By Dr. Jeff Hersh, 
More Content Now DailyTidings.com By Dr. Jeff Hersh, 
More Content Now Posted Oct. 24, 2014 @ 8:20 am By Dr. Jeff Hersh, 
More Content Now Posted Oct. 24, 2014 @ 8:20 am » Social News Q: What’s up with the controversy about breast cancer screening? A: Many factors must be considered to evaluate a screening test: - How common is the disease being screened for? The more common it is, the more people there are that potentially may benefit from screening. - Are there subsets of the population that have an increased risk for the disease being screened for? If this is the case, screening might only be indicated in some people. - Are there any risks from the screening test? The risk of screening may affect the benefit/risk evaluation. For example, the procedure for colon cancer screening (colonoscopy) carries a small, but non-zero, risk of complication; however the benefit has been determined to outweigh this small risk. - What are the consequences of the condition if it is not detected, and what are the benefits from early detection? If screening identifies a risk factor, early treatment might prevent or improve the outcome of the condition; for example screening for cholesterol and blood pressure can prevent or slow the progression of cardiovascular disease. For many cancers, early detection can improve outcomes. - Is the screening cost effective? The U.S. Preventive Services Task Force (USPSTF) looks at many factors, including the cost per quality-adjusted year of life saved (QALY). - Other factors. How does all this apply to breast cancer? Breast cancer is the most common non-skin cancer diagnosed in women, and behind lung cancer it is the second leading cause of cancer deaths in women. In the U.S. breast cancer is diagnosed in over 200,000 women annually, and sadly it claims the lives of approximately 40,000; it is a very common disease. About 90 percent of all breast cancer cases are spontaneous, meaning they arise from a combination of risk factors (some of which are known and some that remain unknown) that alter the breast cell’s DNA to cause mutations that lead to cancer. So although about 5 percent to 10 percent of all breast cancer cases are due to a genetic predisposition, screening only these patients would miss the overwhelming majority of all breast cancer cases. Mammography, the standard initial screening for breast cancer in most women, utilizes ionizing radiation. However, the risk of the low levels of radiation needed for this test is very small. Other adjunctive screening modalities, such as ultrasound and MRI, are thought to carry even more minimal risks. Many cases of ductal carcinoma in situ (DCIS), which accounts for about 25 percent of all breast cancers diagnosed in the U.S., may be self-limited and not progress to cause problems. This has brought up the question as to whether breast cancer is being "over-diagnosed." Unfortunately, there is presently no completely reliable way to distinguish which cases of DCIS will become life threatening and which will not. This has created some of the controversy surrounding breast cancer screening. The five-year survival rate for stage 1 breast cancer (the earliest stage) is 90 percent to 100 percent, but the five-year survival for stage 4 (where the cancer has already spread outside the breast and lymph nodes to other distant places on the body) may be as low as 25 percent; the benefit of diagnosing breast cancer early is quite clear. Furthermore, some early stage disease may be treated less invasively, for example by lumpectomy (often with adjuvant radiation therapy) rather than mastectomy; this additional option is very important for many women. However, as treatments improve, especially for later stage cancers, the benefits of screening may actually become less. The cost effectiveness of breast cancer screening has been extensively evaluated. It is generally accepted that a screening test which has cost per QALY of less than $100,000 is cost effective, and breast cancer screening has been determined to be significantly less costly than this. Another question is how often and at what age women should be screened. There are many factors to consider: for example, a younger woman may have a lower risk of breast cancer, but if cancer is detected, the QALY saved is higher. How rapidly breast cancer develops, and therefore how frequently screening is required to identify the disease in earlier stages where treatments are more effective, must also be evaluated. The conclusion: breast cancer screening saves many lives. In fact, the majority of breast cancers diagnosed in the U.S. are a result of screening and there is more evidence supporting the benefits of breast cancer screening than there is for screening of any other kind of cancer. Women should see their healthcare provider to determine what screening is best for them. Jeff Hersh, Ph.D., M.D., can be reached at [email protected] .   By Dr. Jeff Hersh, 
More Content Now DailyTidings.com By Dr. Jeff Hersh, 
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