Opinion

Feds' Outdated Cancer Advice Deadly To Patients

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Posted: Aug 14, 2019 12:01 AM
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Feds' Outdated Cancer Advice Deadly To Patients

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When it comes to protecting yourself from cancer, don't take the government's word. Listen to the experts.

The biggest cancer killer isn't smoking or a chemical in the environment or even an inherited gene. It's the failure to screen patients at high risk of the disease. Curing cancer is about detecting it early, while it's still treatable.

Blame a small, unelected national board that doesn't include a single specialist who actually treats cancer patients. Thanks to the Affordable Care Act, this board has the power to dictate the cancer tests insurance must cover and to influence your doctor.

This board, with the misleading name U.S. Preventive Services Task Force, isn't preventing cancer deaths. It's doing the opposite, by discouraging screening.

President Donald Trump promises that if reelected, he's going to make huge progress against cancer. His first step should be to make sure oncologists, radiologists and surgeons who treat cancer patients are added to the task force, which is under the Department of Health and Human Services. Cancer patients and their doctors deserve experts in their disease calling the shots.

Last week, the task force recommended against screening for pancreatic cancer, the kind that killed tenor Luciano Pavarotti and astronaut Sally Ride. Jeopardy host Alex Trebek is battling it right now, and 57,000 Americans are diagnosed with it each year. The task force gave pancreatic cancer screening its worst rating, a D, meaning don't do it. That's OK for the general population, but the task force failed to expressly recommend screening for people with a family history of pancreatic cancer. That's a deadly mistake.

Similarly, the task force has waffled over lung cancer screening, leading to tens of thousands of needless deaths a year.

Pancreatic cancer has a dismal 9% survival rate, partly because it's diagnosed late, when it's spread too far to be surgically removed.

Dr. Diane Simeone, director of the Pancreatic Cancer Center at NYU's Perlmutter Cancer Center, explains the task force should have recommended screening for people at high risk. Who are they? Patients with a family history of pancreatic cancer or a blood test indicating inherited risk. Screening means getting an annual MRI or endoscopic ultrasound of the pancreas. "If you screen someone and find something, the odds that you can do surgery are 80 to 90 percent."

The task force claims these surgeries are dangerous. But Simeone suggests the task force's data is obsolete, some of it going back as far as 2003. "It's now 2019," and the mortality rate at "highly experienced" medical centers for these procedures is less than 1%.

On Monday, scientists from Dana-Farber/Brigham and Women's Cancer Center in Boston announced their discovery of an additional inherited gene mutation causing pancreatic cancer. It occurs in the RABL3 gene, and people carrying it should be screened. "Catching pancreatic cancer through screening of high-risk individuals" will make it more treatable, the scientists explain.

Take note, Mr. President.

As for lung cancer, in 2011, the National Lung Cancer Screening Trial made a splash with an announcement that "screening with the use of low-dose CT (computed tomography) reduces mortality from lung cancer" by double digits. Despite this compelling evidence, the task force equivocated, recommending screening for current and former smokers only if they first undergo counseling with their physician about possible false positives and overtreatment.

Requiring counseling has been the kiss of death for screening because too few family doctors know the data and can afford the time.

Only 4% of people at high risk for lung cancer get screened. Dr. Brendon Stiles, a thoracic surgeon at Weill Cornell, calls that "unconscionable." At least 80% of lung cancer detected with a CT scan is curable, compared with the current 19% overall lung cancer survival rate.

Dr. Claudia Henschke, a pioneer in CT scanning and director of the Lung Cancer Screening Program at Mount Sinai hospital, briefed Congress on July 23, saying, "Screening can find lung cancers when they are still highly curable."

Trust cancer experts, not the archaic advice from Uncle Sam's task force. Americans deserve better.

Betsy McCaughey is a former lieutenant governor of New York State. Contact her at betsy@betsymccaughey.com.