Health
Ohio General Assembly is expanding the scope of breast cancer screening
Since she turned 40, Summit County resident Tamara Eggleton has made every year an X-ray mammogram. Despite the dense breasts, there was nothing to worry about in each test.
Last year, Égletons began to feel an abnormal breast sensation. She looked for tomosynthesis (a more advanced 3D version of the mammogram) and breast ultrasound. All signs of cancer turned out to be negative.
There was another test option left: MRI. However, given the results of previous screenings, her doctor said that Egleton insurance would probably not cover it.
“That day, many years of repeated refusals by insurance became my caregiver,” Eggleton said. “It wasn’t my health or the best screening test for me. It was about money.”
Eggleton, now 47, finally discovered that she was already in the advanced stages of breast cancer after choosing self-paying high-speed MRI. Last year it was full of surgery, chemotherapy, radiation therapy and other treatments.
Such anecdotes have spurred Republicans and Democrats not only to expand the coverage of breast screening, but also to promote state law to raise awareness of the risks posed by dense breasts. ..
“Until recent experience, I was unaware that there were better options for early detection of breast cancer,” Eggleton said. “But now I know.”
Breast Dense: Impaired Early Detection
Breast cancer affected more than 11,800 women in Ohio in 2018, according to the latest report. data From the Ohio Department of Health, black women die at a higher rate from the disease.
Mammogram screening is recommended for older women as a way to detect early signs of breast cancer. This increases your chances of survival.
However, due to genetic and environmental factors, about 40% of all women have a dense breast. Some studies show that black women are more likely to have dense breasts. Dense tissue can obscure the cancer and make it difficult to detect, and density also increases the risk of cancer.
Tomosynthesis can increase the chances of detecting high-density breast cancer, which is usually overlooked in normal mammograms. Further methods such as ultrasound or MRI may be needed to find the cancer.
But if women don’t look for them in the first place, all these extra techniques are useless.
Ohio, like the other 37 states, needs to notify patients if their breasts are dense. But the way the law writes the statement does not express enough urgency, breast cancer survivors said.
“I didn’t know how vulnerable I was until I was diagnosed and learned all these things,” he said. Michelle YoungA woman in the Cincinnati region whose experience in fighting breast cancer has led to a new bill. “I was misunderstood about the extreme nature of my risk. Otherwise, of course, my god would have insisted on MRI.”
Currently, the notice only states that the problem of breast congestion is “can hide abnormalities” and is a “relatively common condition”. He adds that it is not about raising concerns, but about raising awareness and encouraging discussions with doctors about possible risk factors.
Part of House building 371 Change the text to clarify that dense breasts can make it difficult to find cancer in the mammogram and can increase the risk. It directly encourages the patient to see additional tests.
Ultimately, text changes are expected to increase the chances of early detection of cancer in women with dense breasts.
Scope of health insurance
Looking for additional breast cancer tests is one thing. Apart from paying it. Therefore, HB 371 wants to make sure that money is not the reason why women with dense breasts cannot get the necessary tests.
Currently, the law simply requires insurers to cover mammogram screening once a year or once every two years, depending on age and risk factors.
The bill also eliminates these factors, provides comprehensive annual compensation, and also specifies that tomosynthesis is included.
“This will allow patients and their healthcare providers to decide when to start screening mammograms based on individual risk factors, removing barriers to determining insurance coverage,” he said. I am.William Farrer, The Ohio State University Cancer Center.
Most insurers already offer tomosynthesis coverage, Farah said. However, it is not mandatory and the coverage is not guaranteed. Therefore, when told, the patient refuses it for fear of out-of-pocket costs.
Supplementary screening, such as MRI and ultrasound, should also be targeted at women with dense breast tissue and a family history of breast cancer. Only 12 states require the scope of such legislation.
Many insurance companies “High risk“Columbus-based radiologist Van Huin said. Currently left behind are those who are considered medium risk.
But even high-risk patients need pre-approval, said Anne Brown, a radiologist at the University of Cincinnati. It’s still a tedious process and doesn’t guarantee coverage, Brown said.
Where the bill stands
Mandating additional coverage is costly. According to the bill’s financial analysis, it can increase insurance premiums and increase the cost of employers, including state and local governments.
However, Republican Republican Jean Schmidt, along with D-Cedric Denson, is sponsoring the state bill, but believes there are long-term savings.
“Why don’t we get better results for people and society, and catch them to reduce overall costs?” [the cancer] quickly? “Schmidt said.
The Ohio Health Planning Association has decided to keep the bill neutral and may remove obstacles. There is no consensus among plans on how to tackle the bill, said spokesman Dan Williamson.
Part of the calculus is that at least some parts of bills like tomosynthesis are already somehow provided by a particular plan. This means that the additional costs may not be very high for some insurance companies.
The Ohio branch of the National Federation of Independent Businesses, which represents small businesses, is studying that aspect. If most of the bill turns out to be a common practice in the insurance market, lobbying groups will not stop the bill.
The NFIB is concerned that only small businesses will see higher premiums as large companies tend to use self-insurance plans that cannot be regulated at the state level, said legislative director Chris Felso. He said.
For those who have had breast cancer, the bill is an opportunity to help others avoid the same situation.
“We can save so much, and catching it early can save so many lives,” Young said.
Titus Wu is a reporter for the USA TODAY Network Ohio Bureau, serving the Columbus Dispatch, Cincinnati Enquirer, Akron Beacon Journal, and 18 other relevant news organizations throughout Ohio.
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Sources 2/ https://www.dispatch.com/story/news/healthcare/2021/10/26/ohio-lawmakers-jean-schmidt-insurance-coverage-breast-cancer-screening-mammogram-tomosynthesis-dense/8528977002/ The mention sources can contact us to remove/changing this article |
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