A Blue View

Climate Change Opponents Join With Anti-Evolution Creationists To Spur American's Idiotic Attachment To Denialism

NY Times (For more, see A Blue View's Denialism category and/or buy the book that named the phenomenon: Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives):

Critics of the teaching of evolution in the nation’s classrooms are gaining ground in some states by linking the issue to global warming, arguing that dissenting views on both scientific subjects should be taught in public schools.

In Kentucky, a bill recently introduced in the Legislature would encourage teachers to discuss “the advantages and disadvantages of scientific theories,” including “evolution, the origins of life, global warming and human cloning.”

The bill, which has yet to be voted on, is patterned on even more aggressive efforts in other states to fuse such issues. In Louisiana, a law passed in 2008 says the state board of education may assist teachers in promoting “critical thinking” on all of those subjects.

Last year, the Texas Board of Education adopted language requiring that teachers present all sides of the evidence on evolution and global warming.

Oklahoma introduced a bill with similar goals in 2009, although it was not enacted.

The linkage of evolution and global warming is partly a legal strategy: courts have found that singling out evolution for criticism in public schools is a violation of the separation of church and state. By insisting that global warming also be debated, deniers of evolution can argue that they are simply championing academic freedom in general.

Yet they are also capitalizing on rising public resistance in some quarters to accepting the science of global warming, particularly among political conservatives who oppose efforts to rein in emissions of greenhouse gases.

In South Dakota, a resolution calling for the “balanced teaching of global warming in public schools” passed the Legislature this week.

“Carbon dioxide is not a pollutant,” the resolution said, “but rather a highly beneficial ingredient for all plant life.”

The measure made no mention of evolution, but opponents of efforts to dilute the teaching of evolution noted that the language was similar to that of bills in other states that had included both. The vote split almost entirely along partisan lines in both houses, with Republican voting for it and Democrats voting against.

For mainstream scientists, there is no credible challenge to evolutionary theory. They oppose the teaching of alternative views like intelligent design, the proposition that life is so complex that it must be the design of an intelligent being. And there is wide agreement among scientists that global warming is occurring and that human activities are probably driving it. Yet many conservative evangelical Christians assert that both are examples of scientists’ overstepping their bounds.

John G. West, a senior fellow with the Discovery Institute in Seattle, a group that advocates intelligent design and has led the campaign for teaching critiques of evolution in the schools, said that the institute was not specifically promoting opposition to accepted science on climate change. Still, Mr. West said, he is sympathetic to that cause.

“There is a lot of similar dogmatism on this issue,” he said, “with scientists being persecuted for findings that are not in keeping with the orthodoxy. We think analyzing and evaluating scientific evidence is a good thing, whether that is about global warming or evolution.”

Lawrence M. Krauss, a physicist who directs the Origins Initiative at Arizona State University and has spoken against efforts to water down the teaching of evolution to school boards in Texas and Ohio, described the move toward climate-change skepticism as a predictable offshoot of creationism.

“Wherever there is a battle over evolution now,” he said, “there is a secondary battle to diminish other hot-button issues like Big Bang and, increasingly, climate change. It is all about casting doubt on the veracity of science — to say it is just one view of the world, just another story, no better or more valid than fundamentalism.”

Not all evangelical Christians reject the notion of climate change, of course. There is a budding green evangelical movement in the country driven partly by a belief that because God created the earth, humans are obligated to care for it.

Yet there is little doubt that the skepticism about global warming resonates more strongly among conservatives, and Christian conservatives in particular. A survey published in October by the Pew Research Center for the People and the Press found that white evangelical Protestants were among those least likely to believe that there was “solid evidence” that the Earth was warming because of human activity.

Only 23 percent of those surveyed accepted that idea, compared with 36 percent of the American population as a whole. [For more see New Poll Shows Fewer Americans "Believe" Global Warming]

Denialist Alert: Swine Flu Has Killed 1,000 American Children So Far

If 20 school buses worth of kids were to die in a traffic accident, it would be all over the news for weeks. Yet, when 1,000 unvaccinated children are killed by ignorance, irrational fear or neglect, the news is buried within a minor story in the NY Times health section:

Most Americans do not intend to get the swine flu vaccine, assume the pandemic is over and think the flu threat was overblown, according to a poll released Friday by the Harvard School of Public Health.

As of the end of January, only about a fifth of all Americans had had swine flu shots, according to that poll and data released separately by the Centers for Disease Control and Prevention.

And, even though this flu hit children and teenagers the hardest, only about 40 percent of them have had the shots. That figure could improve because 13 percent of adults surveyed by Harvard told pollsters that they still intended to get their children vaccinated. If they do so, slightly more than half of all the country’s children will have been vaccinated, though many young ones who should have had two shots got only one.

Most parents who did not get shots said they felt the threat had passed. The second-most-common reason was fear of the vaccine, even though monitoring of the first 60 million doses showed no unusual rate of side effects ...

Nine children died of confirmed swine flu in the last week of January, according to weekly data released Friday. The C.D.C. estimates that about 1,000 children have succumbed to it since April.

"Scientists are poorly equipped ... to respond when science comes under attack"

Whether it's the hacked climate emails or evolution, as discussed in this Wash Post article, or mammogram recommendations and vaccine phobia as posted often in A Blue View (for instance, here, here and here), it is clear that scientists need to become better, more effective advocates when they are in the public square.

The battle over the science of global warming has long been a street fight between mainstream researchers and skeptics. But never have the scientists received such a deep wound as when, in late November, a large trove of e-mails and documents stolen from the Climatic Research Unit at Britain's University of East Anglia were released onto the Web.

In the ensuing "Climategate" scandal, scientists were accused of withholding information, suppressing dissent, manipulating data and more. But while the controversy has receded, it may have done lasting damage to science's reputation: Last month, a Washington Post-ABC News poll found that 40 percent of Americans distrust what scientists say about the environment, a considerable increase from April 2007. Meanwhile, public belief in the science of global warming is in decline.

The central lesson of Climategate is not that climate science is corrupt. The leaked e-mails do nothing to disprove the scientific consensus on global warming. Instead, the controversy highlights that in a world of blogs, cable news and talk radio, scientists are poorly equipped to communicate their knowledge and, especially, to respond when science comes under attack.

A few scientists answered the Climategate charges almost instantly. Michael Mann of Pennsylvania State University, whose e-mails were among those made public, made a number of television and radio appearances. A blog to which Mann contributes, RealClimate.org, also launched a quick response showing that the e-mails had been taken out of context. But they were largely alone. "I haven't had all that many other scientists helping in that effort," Mann told me recently.

This isn't a new problem. As far back as the late 1990s, before the news cycle hit such a frenetic pace, some science officials were lamenting that scientists had never been trained in how to talk to the public and were therefore hesitant to face the media.

"For 45 years or so, we didn't suggest that it was very important," Neal Lane, a former Clinton administration science adviser and Rice University physicist, told the authors of a landmark 1997 report on the gap between scientists and journalists. ". . . In fact, we said quite the other thing."

The scientist's job description had long been to conduct research and to teach, Lane noted; conveying findings to the public was largely left to science journalists. Unfortunately, despite a few innovations, that broad reality hasn't changed much in the past decade.

Scientific training continues to turn out researchers who speak in careful nuances and with many caveats, in a language aimed at their peers, not at the media or the public. Many scientists can scarcely contemplate framing a simple media message for maximum impact; the very idea sounds unbecoming. And many of them don't trust the public or the press: According to a recent Pew study, 85 percent of U.S. scientists say it's a "major problem" that the public doesn't know much about science, and 76 percent say the same about what they see as the media's inability to distinguish between well-supported science and less-than-scientific claims. Rather than spurring greater efforts at communication, such mistrust and resignation have further motivated some scientists to avoid talking to reporters and going on television.

They no longer have that luxury. After all, global-warming skeptics suffer no such compunctions. What's more, amid the current upheaval in the media industry, the traditional science journalists who have long sought to bridge the gap between scientists and the public are losing their jobs en masse. As New York Times science writer Natalie Angier recently observed, her profession is "basically going out of existence." If scientists don't take a central communications role, nobody else with the same expertise and credibility will do it for them.

Meanwhile, the task of translating science for the public is ever more difficult: Information sources are multiplying, partisan news outlets are replacing more objective media, and the news cycle is spinning ever faster ...

Swine Flu A "Victory" Over The Denialist, Antivaccine Movement?

In a NY Times article about the government's successful fight against swine flu--thanks to good decision making and a bit of good luck--there was this interesting assessment about it's potential impact on Denialists:

One real triumph, several experts said, was how little damage misinformation did. In 1976, many people refused shots after three elderly Pittsburgh residents died shortly after getting theirs; it took the C.D.C. five days to explain that it was just a coincidence.

This time, many rumors arose but were quickly debunked: That thousands had died in Mexico. That the virus had circulated in the Midwest for a decade, undetected. That it had escaped from a laboratory. That seasonal flu shots made catching swine flu more likely. That flu shots did not work or caused autism. That the administration would make them mandatory. That Tamiflu resistance was widespread in Northern California. That a flu shot had disabled a Washington Redskins cheerleader, or that she was cured by chelation therapy by a doctor associated with the antivaccine movement. That mutant killer flu strains were circulating in Argentina or Ukraine or North Carolina.

The debunking succeeded, Dr. Osterholm said, “despite the fact that there are many fewer reporters who understand medical issues than there used to be.”

This time, both the C.D.C. and the World Health Organization responded quickly to almost every rumor. At the epidemic’s height, they held several news conferences a week, taking questions by phone from all over the world.

They also invited dozens of reporters to daylong seminars on influenza at C.D.C. headquarters in Atlanta and to exercises around the country led by the former anchorman Forrest Sawyer, at which they debated, for example, whether a miscarriage by one woman after getting a flu shot was a big scoop or a nonstory.

Remaining to be seen is what effect the pandemic has had on Americans’ feelings about vaccines.

Dr. Frieden said he thought a victory over the antivaccine movement had been scored. Nearly 60 million people have been vaccinated, including many pregnant women and children, with no surge in side effects.

John P. Moore, an AIDS researcher at Weill Cornell Medical College, was less sure. Dr. Moore, who spent years fighting AIDS denialism, has called skepticism about flu vaccine “an unholy alliance of the left and right” because it joined the liberal natural-medicine proponents with anti-big-government conservatives.

“It’s hard to say if it hurt or helped,” Dr. Moore said, pointing out that polls still show a large minority of Americans rejecting the vaccine. “As with AIDS, people have to die before others understand the consequences of ignoring science-based medicine.”

“It’s unfortunate that ... science can’t just be science’’

Boston Globe:

For Judy Ockene, a University of Massachusetts scientist, breast cancer is not some academic abstraction. It is personal . As a daughter, she watched her mother be diagnosed with the disease at the age of 44 - and survive. As a mother, she has two daughters of her own, one who is 42, another who just turned 40 - the very age when many women first undergo screening for breast cancer.

And now, with an air of dismay, she finds herself swept up in the controversy generated by new guidelines governing mammograms. Ockene, as a member of the US Preventive Services Task Force, helped draft recommendations that advised against routine screening for women in their 40s, which proved so inflammatory that the board’s top officials were summoned before a Congressional committee.

There was, Ockene said, never any contest between personal experience and scientific evaluation as she weighed the evidence on mammograms. Nor, she added, should there be.

“We all have our own stories about cancer,’’ said Ockene, a disease prevention specialist at the UMass Medical School. “But evidence is extremely important in all the work we do in health care. Does it mean it’s more important than all of the personal experiences? Well, I think it does. The evidence has to speak for itself.’’

But for the public, personal experience is often paramount. After the breast screening guidelines were released last month, media coverage overflowed with stories of women in their 40s whose tumors had been found with mammography, and who credited the scans with saving their lives.

Their consternation offers both a cautionary tale and a foreshadowing. “comparative effectiveness research,’’ promising to exhaustively assess the strengths and weaknesses of medical treatments. With money from the economic stimulus package, and possibly from the pending health care overhaul legislation, the federal government is expanding its use of

“If we’re really going to do comparative effectiveness research, there are going to be studies that show the tried-and-true things that we think are right aren’t really as good as we thought,’’ said Dr. Laura Esserman, a breast cancer specialist at the University of California, San Francisco.

“There’s a cultural acceptance that more is always better, and that explains why our health care costs get out of control,’’ Esserman said. “We have to understand there are limits to what we can do.’’

Ockene has been down this road before: She helped direct a study that drastically altered attitudes toward use of hormones in women after menopause. It was a reminder that science is rarely a linear pursuit. The medical landscape is pocked with reversals, yesterday’s panacea branded as today’s poison.

Mammograms themselves have been subject to course corrections: In 2002, the Preventive Services Task Force advised that screening start at 40. The panel updates its advice every five years, and so, in 2007, it enlisted a separate group of scientists to analyze eight mammogram studies. When that review failed to answer all of the task force’s questions, the panel commissioned elaborate statistical models to further assess benefit and risk.

“It’s unfortunate that things like this become so politicized, that science can’t just be science,’’ Ockene said.

At Home With The Denial Family (cartoon)

 

Not Surprising: There Are More Red Than Blue Denialists

Sharon Begley:

The fact that Republicans and Democrats differ on whether health-care reform should include a public option is no surprise. That they differ on setting a date for exiting Afghanistan, sure. On Sarah Palin, of course. But on physics? And biology? That the growing list of issues where there is a partisan divide now includes the accuracy of scientific findings may be lamentable for a democracy (if we can't agree on facts, how can we agree on policy?), but it's a gold mine for research on how personality and other psychological factors influence political ideology.

The red-blue split on mammograms is particularly striking. In a recent poll, the Pew Research Center asked 1,002 American adults about a preventive-health task force's conclusion that most women can safely begin mammograms at age 50, not 40, and have one every two years, not annually. (Large studies have found that earlier mammograms save almost no lives; since the radiation can cause cancer, it therefore makes sense to minimize them.) Among Republicans, 15 percent agreed with that. Among Democrats? Twice as many.

One reason, of course, is that the mammogram wars have become entangled in health-care reform, with accusations that the advice is part of a dastardly plot to ration care. Some of the partisan split therefore reflects red-blue views of what John Jost of New York University, who studies the psychological basis of political ideology, calls "a softer version of the 'death panel' claim." But something else is going on, something that speaks to how traits of personality affect political leanings. Since people do not pore over oncology studies and reach their own conclusion on the credibility of the science, they have to trust experts—or not. And thus the partisan divide: Republicans tend to distrust "elites," especially now that the GOP is more Palin than George H.W. Bush or other scion of the white-shoe establishment. In the mammogram debate, that distrust encompasses pointy-headed scientists and makes those who disdain "the reality-based community," as an aide to George W. Bush called scientists, go with the "common sense" view that mammograms save lives.

There is a long list of personality differences between liberals or Democrats and conservatives or Republicans. The former are generally more open to new experiences and ideas, Jost and colleagues found in a 2003 study. The latter tend to be more conscientious, more energetic, and more emotionally stable, Jost later found, as did a 2007 study of 5,623 voters led by Chris Fraley of the University of Illinois at Urbana-Champaign. The differences are significant: the personality traits predict voting decisions more strongly than age or gender, Fraley found.

The partisan divide on another empirical question—whether Earth is warming, and if so whether that is due to human activities—may reflect something similar.

Surprise: The Senate Compromise Might Actually Be Better At Containing Costs. Denialists Beware!

Karen Tumulty's analysis indicates the final bill will be better at containing costs than the original Senate version: principally by strengthening a Federal medical oversight board that will make decisions based on science not politics:

Given the drama and suspense of the past few weeks, it's understandable that the first round of commentary about the new Senate health bill would focus on the deals that Majority Leader Harry Reid had to make to bring aboard all 60 of the votes that he will need to beat a Republican filibuster ...

But while you might think that all this horsetrading would produce a weaker and more bloated bill, it appears that, by some measures at least, the opposite may have happened. The preliminary analysis suggests that the new bill would actually be more effective than the previous version in reining in health care costs in the long term. To use the current Washington cliche, it would do a better job "bending the curve." Congressional Budget Office Director Douglas Elmendorf put it this way in his blog:

Relative to the legislation as originally proposed, the expected reduction in deficits during the 2020–2029 period is larger for the legislation incorporating the manager's amendment. Most of that difference arises because the manager's amendment would lower the threshold for Medicare spending growth that would trigger recommendations for spending reductions by the Independent Payment Advisory Board.

What Elmendorf is talking about is this: As I had written a couple of weeks ago, Reid's earlier bill had taken the teeth out of one of the proposals that economists had considered a "game changer." It is a new board that would come up with proposals to bring down Medicare costs, largely taking the job out of Congress' hands. (Medicare is such a big player in the overall health market, spending more than $450 billion a year, that the private industry often follow its lead.)

Reid's earlier version would not have allowed the board to act unless Medicare spending grew faster than overall health care spending--something that pretty much doesn't happen these days. The new version is signficantly stronger, thanks in no small part to pressure from the Obama White House and a group of reform-minded freshman Senators. It would trigger action from the board if growth in health care spending exceeds that of Medicare spending, which is pretty much guaranteed to be the case.

All of that sounds pretty technical, but getting the details right is the difference between a health care bill that will work and one that won't, economists say. And many experts have been worried about the direction the bill appeared to be headed.

There's also another potentially significant improvement buried down in fine print of the bill:

"Why not monthly mammograms beginning at age 15?"

John Allen Paulos mounts the defense I've been waiting to see for evidence-based medicine. I particularly like his reductio ad absurdum, argument as it's the anti-Denialism one I've been privately making for weeks:

In his inaugural address, Barack Obama promised to restore science to its “rightful place.” This has partly occurred, as evidenced by this month’s release of 13 new human embryonic stem-cell lines. The recent brouhaha over the guidelines put forth by the government task force on breast-cancer screening, however, illustrates how tricky it can be to deliver on this promise. One big reason is that people may not like or even understand what scientists say, especially when what they say is complex, counterintuitive or ambiguous.

As we now know, the panel of scientists advised that routine screening for asymptomatic women in their 40s was not warranted and that mammograms for women 50 or over should be given biennially rather than annually. The response was furious. Fortunately, both the panel’s concerns and the public’s reaction to its recommendations may be better understood by delving into the murky area between mathematics and psychology.

Much of our discomfort with the panel’s findings stems from a basic intuition: since earlier and more frequent screening increases the likelihood of detecting a possibly fatal cancer, it is always desirable. But is this really so? Consider the technique mathematicians call a reductio ad absurdum, taking a statement to an extreme in order to refute it. Applying it to the contention that more screening is always better leads us to note that if screening catches the breast cancers of some asymptomatic women in their 40s, then it would also catch those of some asymptomatic women in their 30s. But why stop there? Why not monthly mammograms beginning at age 15?

The answer, of course, is that they would cause more harm than good. Alas, it’s not easy to weigh the dangers of breast cancer against the cumulative effects of radiation from dozens of mammograms, the invasiveness of biopsies (some of them minor operations) and the aggressive and debilitating treatment of slow-growing tumors that would never prove fatal.

The exact weight the panel gave to these considerations is unclear, but one factor that was clearly relevant was the problem of frequent false positives when testing for a relatively rare condition. A little vignette with made-up numbers may shed some light. Assume there is a screening test for a certain cancer that is 95 percent accurate; that is, if someone has the cancer, the test will be positive 95 percent of the time. Let’s also assume that if someone doesn’t have the cancer, the test will be positive just 1 percent of the time. Assume further that 0.5 percent — one out of 200 people — actually have this type of cancer. Now imagine that you’ve taken the test and that your doctor somberly intones that you’ve tested positive. Does this mean you’re likely to have the cancer? Surprisingly, the answer is no.

To see why, let’s suppose 100,000 screenings for this cancer are conducted.

Another Interview With Denialism's Author

Not the best explanation of Denialism, but interesting given the forum (for more, check out the A Blue View category Denialism or buy the book):

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Michael Specter
www.thedailyshow.com
Daily Show Full Episodes Political Humor Health Care Crisis

1st Senate Amendment Is Approved: Free Preventative Services For Women

NY Times:

The Senate voted Thursday to require health insurance companies to provide free mammograms and other preventive services to women ... The 61-to-39 vote on health benefits for women would, in effect, override new recommendations from a federal advisory panel that said routine mammograms should begin at age 50, rather than 40.

Senator Barbara A. Mikulski, Democrat of Maryland, who proposed the coverage requirement as an amendment to sweeping health legislation, said it could save millions of lives.

“My amendment would eliminate one of the major barriers to care by getting rid of high co-payments and deductibles,” Ms. Mikulski said. “It does not tell women, ‘You will have a mammogram at 40.’ It says, ‘You will have access to that mammogram if you and your doctor decide it’s medically necessary or medically appropriate.’ ” ...

Under Ms. Mikulski’s proposal, a federal agency, the Health Resources and Services Administration, would develop “comprehensive guidelines” recommending preventive care and screenings for women, and insurers would have to cover the services without any cost-sharing.

Ms. Mikulski said the services would include screenings for breast, cervical, ovarian and lung cancer, heart disease and diabetes, as well as postpartum depression and domestic violence.

The underlying bill would eliminate deductibles and co-payments for many preventive services for men, women and children. But Ms. Mikulski said it did not adequately address the “unique needs” of women.

Senator Olympia J. Snowe, Republican of Maine, was a co-sponsor of the Mikulski amendment. She and two other Republican senators, Susan Collins of Maine and David Vitter of Louisiana, joined 56 Democrats and 2 independents in voting for the amendment. Two Democrats, Russ Feingold of Wisconsin and Mr. Nelson, voted no.

Mr. Feingold said the Senate should have found a way to pay the cost of Ms. Mikulski’s proposal, estimated at $940 million over 10 years. Mr. Nelson said the amendment should have explicitly excluded abortion from the definition of preventive care.

The Mountain Out Of A Molehill Emails

 

The Copenhagen Diagnosis: "Updating the world on the Latest Climate Science"

A new report has been released that "serves as a handbook of science updates ... in time for Copenhagen in December 2009, and any national or international climate change policy negotiations that follow ... The report has been purposefully written with a target readership of policy-makers, stakeholders, the media and the broader public." From their press release:

Climate change accelerating beyond expectations, urgent emissions reductions required, say leading scientists

Global ice-sheets are melting at an increased rate; Arctic sea-ice is disappearing much faster than recently projected, and future sea-level rise is now expected to be much higher than previously forecast, according to a new global scientific synthesis prepared by some of the world’s top climate scientists.

In a special report called ‘The Copenhagen Diagnosis’, the 26 researchers, most of whom are authors of published IPCC reports, conclude that several important aspects of climate change are occurring at the high end or even beyond the expectations of only a few years ago.  

The report also notes that global warming continues to track early IPCC projections based on greenhouse gas increases.  Without significant mitigation, the report says global mean warming could reach as high as 7 degrees Celsius by 2100.

The Copenhagen Diagnosis, which was a year in the making, documents the key findings in climate change science since the publication of the landmark Intergovernmental Panel on Climate Change (IPCC) Fourth Assessment Report in 2007.

The new evidence to have emerged includes:

• Satellite and direct measurements now demonstrate that both the Greenland and Antarctic ice-sheets are losing mass and contributing to sea level rise at an increasing rate.
• Arctic sea-ice has melted far beyond the expectations of climate models. For example, the area of summer sea-ice melt during 2007-2009 was about 40% greater than the average projection from the 2007 IPCC Fourth Assessment Report.
• Sea level has risen more than 5 centimeters over the past 15 years, about 80% higher than IPCC projections from 2001. Accounting for ice-sheets and glaciers, global sea-level rise may exceed 1 meter by 2100, with a rise of up to 2 meters considered an upper limit by this time.  This is much higher than previously projected by the IPCC.  Furthermore, beyond 2100, sea level rise of several meters must be expected over the next few centuries.
• In 2008 carbon dioxide emissions from fossil fuels were ~40% higher than those in 1990. Even if emissions do not grow beyond today’s levels, within just 20 years the world will have used up the allowable emissions to have a reasonable chance of limiting warming to less than 2 degrees Celsius.

The report concludes that global emissions must peak then decline rapidly within the next five to ten years for the world to have a reasonable chance of avoiding the very worst impacts of climate change.

To stabilize climate, global emissions of carbon dioxide and other long-lived greenhouse gases need to reach near-zero well within this century, the report states.

Read the summary or full report.

Denialism: New Poll Shows Fewer Americans "Believe" Global Warming

Why am I not surprised the shift has primarily occurred within the science-phobic GOP (for more on the subject, see A Blue View's Denialism category and/or buy the book that named the phenomenon: Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives). From the Wash Post:

The percentage of Americans who believe global warming is happening has dipped from 80 to 72 percent in the past year, according to a new Washington Post-ABC News poll, even as a majority still support a national cap on greenhouse gas emissions.

The poll's findings -- which also show that 55 percent of respondents think the United States should curb its carbon output even if major developing nations such as China and India do less -- suggest increasing political polarization around the issue, just as the Obama administration and congressional Democrats are intensifying efforts to pass climate legislation and broker an international global warming pact.

The increase in climate skepticism is driven largely by a shift within the GOP. Since its peak 3 1/2 years ago, belief that climate change is happening is down sharply among Republicans -- 76 to 54 percent -- and independents -- 86 to 71 percent. It dipped more modestly among Democrats, from 92 to 86 percent. A majority of respondents still support legislation to cap emissions and trade pollution allowances, by 53 to 42 percent.

Amanda Feinberg, a retired administrative assistant living in South Williamsport, Pa., said she became disenchanted with the idea of human-caused global warming when former vice president Al Gore launched a public awareness campaign with his documentary, "An Inconvenient Truth."

"He just seemed a little radical in his views," said Feinberg, a Republican. "I don't deny it's happening, I just think it's just an evolution of nature."

Lisa Woolcott, another Republican poll respondent, said she doesn't think that burning fossil fuels is "causing all the global warming," adding: "We can't control what happens in the atmosphere." But Woolcott, a physician's assistant who lives in Kansas City, Kan., said she supports the idea of a bill that would cap the nation's greenhouse gas emissions and doesn't think the United States should predicate its actions on what other nations do. "We need to do what's best for us," she said. "I don't think we should back down."

Even proponents of action on climate change, such as Democratic pollster Mark Mellman, who has conducted polls on the issue for the American Security Project and the Pew Charitable Trusts, say they have detected a recent fraying of bipartisanship.

"It's a sad state of affairs when science becomes subject to partisan politics," Mellman said. "It can only be attributed to the sense that this issue has become part of a political battle."

The Mammography Firestorm Makes It "blindingly obvious: health-care reform that actually controls costs--rather than just pretending to do so--would be virtually impossible to achieve"

Eugene Robinson:

The uproar over the on-again, off-again guidelines on when women should have mammograms is proof of the blindingly obvious: Health-care reform that actually controls costs -- rather than just pretending to do so -- would be virtually impossible to achieve.

I say "would be" because none of the voluminous reform bills being shuttled around the Capitol on hand trucks even tries to address a central factor that sends costs spiraling out of control, which is that each of us wants the best shot at a long, healthy life that medical science can offer. Just as all politics is local, all health care is personal. Skimping on somebody else's tests and procedures may be worth debating, but don't mess with mine.

Intellectually, it's simple to understand why it might make sense for women -- those who have no special risk factors for breast cancer -- to wait until they're 50, rather than 40, to start getting mammograms. The analysis by the U.S. Preventive Services Task Force, which made the recommendation, looks sound. According to the panel, a whopping 10 percent of mammograms result in false-positive readings that can lead to unjustified worry and unneeded procedures, such as biopsies. In a small number of cases, women are subjected to cancer treatment or even a mastectomy they didn't need.

This harm, the task force reasoned, outweighs the benefits of discovering relatively few cases of fast-growing, life-threatening breast cancer in women in their 40s through annual mammography. It is also true that waiting to begin regular mammograms until a woman reaches 50 -- and reducing the frequency to once every two years, as the task force recommended -- would save a portion of the more than $5 billion spent on mammography in the United States each year.

The problem lies in those relatively few instances when a mammogram does find that a woman in her 40s has a life-threatening tumor, and when early detection saves her life. This scenario may be fairly rare, but it happens. Given the option, many women would rather be safe than sorry -- and safe costs money ....

Each of us should ask ourselves: How much expensive, unnecessary, high-tech testing and treatment am I willing to have our out-of-control health system pay for to save one life, if the life in question might be mine or that of a loved one? The honest answer, I think, is: a whole bunch.

The honest solution is a word that cannot be spoken: rationing. Our system already rations health care based on the individual's ability to pay. Insurance companies ration some tests and procedures based on age, risk factors and what often seems like whim. This ad hoc rationing doesn't work very well, and nothing in any of the reform bills even tries to address the basic consensus that makes spending continue to rise: Put a lid on everybody else's costs, but don't touch mine.

Dr. Nancy Sneiderman: A Clear, Powerful Opponent Of Denialism

Dr. Nancy makes a compelling case for the scientific method and against knee jerk, pre-judged reactions, on yesterday's Meet The Press:

Visit msnbc.com for Breaking News, World News, and News about the Economy

We Will Not Get A Handle On Medical Costs Until We Acknowledge We're All Going To Die

Last year, the government spent $50 billion in the last two months of a patients life: more than it spends on the Dept of Education or Homeland Security. Much of this money is wasted in futile attempts to keep the natural, inevitable result at bay. Medicare, for instance, will spend $40,000 on a drug that extends breast cancer victims lives by one month (I wonder how many vaccines $40k would buy?).

How much is too much, when is enough enough, and what should our priorities be -- these are the fundamental, rational questions we need to be asking ourselves if we truly want to reform our health care system. Unfortunately, after weeks like the last one, rational, evidence-based discussion of what's appropriate, for whom and when seems even less likely than before. From 60 Minutes:

The Cost of Dying:

Many Americans spend their last days in an intensive care unit, subjected to uncomfortable machines or surgeries to prolong their lives at enormous cost.

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At Home, At Peace:

Dr. Herb Maurer has made a decision about where he will spend his final days.

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Comfort and Costs:

According to oncologist Letha Mills, whose 70-year-old husband Dr. Herb Maurer is terminally ill with cancer, helping people die at home might increase their comfort and create savings in our healthcare system.

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An Interview With Denialism's Author

As regular A Blue View readers know, I'm reading, and have been greatly effected by, Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives.  Here's an interview with the author:

Denialism: The Mammography Furor Is "a Rorschach test of where we are when it comes to the health-care system and health-care reform"

Wash Post:

President Obama's vision for making health care in America more effective and efficient collided for the first time last week with the realities and peculiarities of the nation's health-care system.

As the Senate moved toward its first floor vote on the health-care reform bill, two independent expert groups coincidentally released new guidelines for mammograms and Pap tests aimed at improving treatment for two forms of cancer in women.

Although neither set of recommendations was aimed at cutting costs, both were based on the kind of objective analysis of scientific research that the Obama administration has embraced in its bid to make care better and more economical.

But after the recommendations unleashed fierce criticism, controversy and debate, the administration appeared to quickly distance itself from the mammography guidelines to try to prevent the uproar from endangering a domestic priority.

"This tells us an awful lot more about where we are as a country in terms of our relationship to the health-care system and health-care reform than they do provide new information about how often women should get screened," said John Abramson, a clinical instructor at Harvard Medical School and a leading proponent of eliminating unnecessary care. "It's like a Rorschach test of where we are when it comes to the health-care system and health-care reform."

Nancy-Ann DeParle, director of the White House Office for Health Reform, said Saturday that the debate over the guidelines goes to the heart of "the unique doctor-patient relationship in the American health-care system and the desire to preserve that."

"Today many of these decisions are being made by insurance companies and bureaucrats, and we want to make sure those decisions are made by doctors," DeParle said.

'Evidence-based' care

The recommendations about mammograms and Pap tests are the latest in a series of guidelines that have been emerging as part of "evidence-based" medicine. The seemingly obvious idea behind the movement is to base medical decisions on the best available scientific evidence, including "comparative effectiveness" studies, instead of relying on tradition, intuition or personal experience.

"One of the things I think you're seeing is the maturation of the concept of evidence-based medicine," said Ned Calonge, chairman of the U.S. Preventive Services Task Force, the federally appointed panel that issued the new mammography guidelines.

Yesterday's Medical Test Whose Use Is Being Decided By A Popularity Contest: The Right & Wrong Ways To Debate The Mammogram Recs

Here's a perfect example of Denialism from the Chris Mathews show. Notice how no doctors or scientists are presented, very few scientific/medical objections are raised to the new mammogram recommendation and the few that are, are generally wrong (sorry Bazell, risk reward analysis is science). And while I generally like Congresswoman Debbie Wasserman-Schulz, having been a breast cancer patient does not make you an oncologist and its therefore wildly inappropriate of her to be offering medical advice (especially when she has the power to codify her personal opinions into law):

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Now contrast that approach with this one presented on another MSNBC show, one actually hosted by a medical doctor, Dr Nancy Sneiderman. Perhaps not surprisingly, she sets the entire debate between medical professionals and they focus their comments on the science. It's also worth noting how the American Cancer Society rep seems to have an agenda designed to scare people (any chance so it's they keep donating to his group?). Notice how Dr. Nancy and the other expert both strongly object to the misleading way he presents the statistical data. 

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We need to be seeing more of Dr. Nancy's approach and less of Chris Mathews: the only valid way to rebut the new mammogram & pap smear recommendations is a debate of their scientific & medical merits.

My point about Denialism is that the way the panel's recommendations are generally being rebutted in the media--by talking heads expressing their personal opinions, beliefs & preconceived biases--is not the way to do it. That's not science, that's religion.

"Sebelius's cave-in on mammograms is a setback for health-care reform"

Steven Pearlstein:

Health and Human Services Secretary Kathleen Sebelius did a marvelous job this week of undermining the move toward evidence-based medicine with her hasty and cowardly disavowal of a recommendation from her department's own task force that women under 50 are probably better off not getting routine annual mammograms.

This is an old issue that has not only sharply divided the medical community for more than 20 years, but also taps into deep resentments among women who, over the years, have felt neglected by a male-dominated medical establishment. And there's no doubt that the advisory panel's recommendation came at a politically inconvenient time, just as Congress enters the crucial final phase in a health reform debate in which opponents have successfully stoked fears of medical rationing.

But rather than showing the leadership necessary to lead a grown-up national discussion on how to eliminate unnecessary or wasteful procedures, Sebelius simply disowned the task force and ran for political cover. Just as the hysteria over "death panels" killed any chance that Medicare recipients and their patients might be encouraged to engage in an intelligent conversation about end-of-life care before it becomes an issue, the mammogram brouhaha is likely to set back efforts to dramatically increase research into what really works and what doesn't, and use the results to revamp the way medical care is delivered and paid for.

I should acknowledge that I have no idea who should and should not get routine mammograms. But I know enough about statistics to say that the issue is not settled just because you know of someone in her 40s whose breast cancer was detected by a mammogram and cured. As economists and medical researchers are fond of saying, the plural of anecdote is data.

To make a valid scientific finding of who should be screened and how often, you'd have to take into consideration how big the risk is that women are likely to develop cancer at any particular age; how fast tumors are likely to grow and how likely they are to be cured once they are caught; what is the likelihood that a tumor detected by mammogram might be found some other way; what is the probability that a suspected tumor turns out not to be pre-cancerous, or that doing a biopsy on it will actually increase the chance that it could become dangerous later. You'd also have to weigh the benefits of routine screening -- deaths avoided and years of life extended -- against the medical problems caused by complications that arise from biopsies, along with the mental anguish that goes along with the large number of false positives that crop up on mammographies of women in their 40s.

All that, of course, is exactly what the task force did, based on numerous studies done in different countries using different methodologies. In the end, it found that while some lives might be saved each year, the benefits of annual screening of women in their 40s were outweighed by the costs -- and that's without even getting into the financial costs, which run to several billion dollars a year.

As is often the case in such matters, those raising the most fuss were those with greatest financial interest in mammography (the radiologists and the makers of mammography machines) and the disease groups (in this case, the American Cancer Society), which tend to resist recognizing limits on how much time, money and attention is devoted to their cause.

"How many mothers, sisters, aunts, grandmothers, daughters and friends are we willing to lose to breast cancer while the debate goes on about the limitations of mammography?" Otis Brawley, chief medical officer of the American Cancer Society, asked in an op-ed article in Thursday's Washington Post. Dr. Brawley cleverly didn't answer his own question, but the clear implication of his question was that the only acceptable number should be zero. And it is that very attitude, applied across the board to every patient and every disease, which goes a long way in explaining why ours is the most expensive, and one of the least effective, health-care systems in the industrialized world.

The political argument from the White House was that it was necessary to duck this fight over evidence-based medicine in order to save it. The better approach would have been to see this as one of those teachable moments that could be used to reaffirm the entire rationale for reform. For while debate continues over whether some women may be getting too many mammograms, there is evidence that there are women who, because they lack insurance, are getting too few -- and dying unnecessarily as a result. What health reform is about is correcting that imbalance while devising new mechanisms for improving health outcomes and getting better control over costs.

Put in that context, it would have been perfectly reasonable for Sebelius to have announced that she was delaying implementation of the task force recommendation for a year in order to give it more time to seek a broader consensus among researchers, doctors and patients. That would have made clear that the administration remained committed to a health-care system driven by the best medical evidence but one that is also sensitive to broad public opinion. This is a tough-love message the country, and the Congress, need to hear.

Time To Adjust Our Thinking: Sometimes Doing Less Is Best For You

NY Times:

This week, the science of medicine bumped up against the foundations of American medical consumerism: that more is better, that saving a life is worth any sacrifice, that health care is a birthright.

Two new recommendations, calling for delaying the start and reducing the frequency of screening for breast and cervical cancer [see The Next Medical Test Whose Use Will Be Decided By A Popularity Contest], have been met with anger and confusion from some corners, not to mention a measure of political posturing.

The backers of science-driven medicine, with its dual focus on risks and benefits, have cheered the elevation of data in the setting of standards. But many patients — and organizations of doctors and disease specialists — find themselves unready to accept the counterintuitive notion that more testing can be bad for your health.

“People are being asked to think differently about risk,” said Sheila M. Rothman, a professor of public health at Columbia University. “The public state of mind right now is that they’re frightened that evidence-based medicine is going to be equated with rationing. They don’t see it in a scientific perspective.”

For decades, the medical establishment, the government and the news media have preached the mantra of early detection, spending untold millions of dollars to spread the word. Now, the hypothesis that screening is vital to health and longevity is being turned on its head, with researchers asserting that mammograms and Pap smears can cause more harm than good for women of certain ages.

On Monday, the United States Preventive Services Task Force, a federally appointed advisory panel, recommended that most women delay the start of routine mammograms until they are 50, rather than 40, as the group suggested in 2002. It also recommended that women receive the test every two years rather than annually, and that physicians not train women to perform breast self-examination.

The task force, whose recommendations are not binding on insurers or physicians, concluded after surveying the latest research that the risks caused by over-diagnosis, anxiety, false-positive test results and excess biopsies outweighed the benefits of screening for women in their 40s. It found that one cancer death is prevented for every 1,904 women ages 40 to 49 who are screened for 10 years, compared with one death for every 1,339 women from 50 to 74, and one death for every 377 women from 60 to 69.

On Friday, the American College of Obstetricians and Gynecologists plans to announce a similar revision to its screening guidelines for cervical cancer [see The Next Medical Test Whose Use Will Be Decided By A Popularity Contest] ...

“A review of the evidence to date shows that screening at less frequent intervals prevents cervical cancer just as well, has decreased costs and avoids unnecessary interventions that could be harmful,” said Dr. Alan G. Waxman, a professor at the University of New Mexico who directed the process.

The challenge of persuading patients and doctors to accept such standards requires a transformational shift in thinking, particularly when the disease involved is as prevalent, as deadly, and as potentially curable as cancer. How do you convince them that it is in their best interest to play the odds when they have been conditioned for so long to not gamble on health? After all, for the one in 1,904 women in their 40s whose life would be saved by early detection of breast cancer, taking the risk would in retrospect seem a bad choice.

“This represents a broader understanding that the efforts to detect cancer early can be a two-edged sword,” said Dr. H. Gilbert Welch, a professor of medicine at Dartmouth who is among the pioneers of research into the negative effects of early detection. “Yes, it helps some people, but it harms others.”

Dr. Welch said this week’s recommendations could mark a turning point in public acceptance of that notion. “Now we’re trying to negotiate that balance,” he said. “There’s no right answer, but I can tell you that the right answer is not always to start earlier, look harder and look more frequently.”

That concept is proving easier to swallow in the halls of Dartmouth Medical School than in the halls of Congress. Coming as they did at the height of debate over a sweeping health care overhaul, the recommendations have provided fresh ammunition for those who warn that greater government involvement in medical decision-making would lead to rationing of health care. It has not mattered that the breast cancer screening recommendation is only advisory, and that the federal government, the American Cancer Society, and numerous private insurers have said they will not adopt it.

Senator Kay Bailey Hutchison, a Republican who is running for governor of Texas, cited the task force’s screening statistics in a floor speech on Thursday. “One life out of 1,904 to be saved,” Ms. Hutchison said, “but the choice is not going to be yours. It’s going to be someone else that has never met you, that does not know family history.” She added, “This is not the American way of looking at our health care coverage.”

The health care bills in both the House and the Senate would establish commissions to encourage research into the effectiveness of medical tests and procedures, but would not require that the findings be translated into practice or reimbursement policies.

As throughout history, it may take decades for medical culture to catch up to medical science. Dr. Rothman pointed out that it took 20 years for the public to accept the discovery in 1882 that tuberculosis was caused by a bacterium and not by heredity or behavior ...

“It’s going to take time, there’s no doubt about it,” said Louise B. Russell, a research professor at the Rutgers University Institute of Health who has studied whether prevention necessarily saves money (and found it does not always do so). “It’s going to take time in part because too many people in this country have had a health insurer say no, and it’s not for a good reason. So they’re not used to having a group come out and say we ought to do less, and it’s because it’s best for you.”

Today's Medical Test Whose Use Will Be Decided By A Popularity Contest: Pap Smears

There's another medical procedure that we'll use a popularity contest to decide how often, and on whom, it is done. At least that's the likely result of this NY Times report:

New guidelines for cervical cancer screening say women should delay their first Pap test until age 21, and be screened less often than recommended in the past.

The advice, from the American College of Obstetricians and Gynecologists, is meant to decrease unnecessary testing and potentially harmful treatment, particularly in teenagers and young women. The group’s previous guidelines had recommended yearly testing for young women, starting within three years of their first sexual intercourse, but no later than age 21.

Arriving on the heels of hotly disputed guidelines calling for less use of mammography, the new recommendations might seem like part of a larger plan to slash cancer screening for women. But the timing was coincidental, said Dr. Cheryl B. Iglesia, the chairwoman of a panel in the obstetricians’ group that developed the Pap smear guidelines. The group updates its advice regularly based on new medical information, and Dr. Iglesia said the latest recommendations had been in the works for several years, “long before the Obama health plan came into existence.”

She called the timing crazy, uncanny and “an unfortunate perfect storm,” adding, “There’s no political agenda with regard to these recommendations.”

Dr. Iglesia said the argument for changing Pap screening was more compelling than that for cutting back on mammography — which the obstetricians’ group has staunchly opposed — because there is more potential for harm from the overuse of Pap tests. The reason is that young women are especially prone to develop abnormalities in the cervix that appear to be precancerous, but that will go away if left alone. But when Pap tests find the growths, doctors often remove them, with procedures that can injure the cervix and lead to problems later when a woman becomes pregnant, including premature birth and an increased risk of needing a Caesarean.

Still, the new recommendations for Pap tests are likely to feed a political debate in Washington over health care overhaul proposals. The mammogram advice led some Republicans to predict that such recommendations would lead to rationing.

Senator Tom Coburn, a Republican from Oklahoma who is also a physician, said in an interview that he would continue to offer Pap smears to sexually active young women. Democratic proposals to involve the government more deeply in the nation’s health care system, he said, would lead the new mammography, Pap smear and other guidelines to be adopted without regard to patient differences, hurting many people.

“These are going to be set in stone,” Mr. Coburn said.

Senator Arlen Specter, a Pennsylvania Democrat and longtime advocate for cancer screening, said in an interview: “And this Pap smear guideline is yet another cut back in screening? That is curious.” Mr. Specter, who was treated for Hodgkin’s lymphoma in 2005 and 2008, said Congress was committed to increasing cancer screenings, not limiting them.

Representative Rosa DeLauro, Democrat of Connecticut, said that the new guidelines would have no effect on federal policy and that “Republicans are using these new recommendations as a distraction.”

“Making such arguments, especially at this critical point in the debate, merely clouds the very simple issue that our health reform bill would increase access to care for millions of women across the country,” she said.

There are 11,270 new cases of cervical cancer and 4,070 deaths per year in the United States. One to 2 cases occur per 1,000,000 girls ages 15 to 19 — a low incidence that convinces many doctors that it is safe to wait until 21 to screen.

The doctors’ group also felt it was safe to test women less often because cervical cancer grows slowly, so there is time to catch precancerous growths. Cervical cancer is caused by a sexually transmitted virus, human papillomavirus, or HPV, that is practically ubiquitous. Only some people who are exposed to it develop cancer; in most, the immune system fights off the virus. If cancer does develop, it can take 10 to 20 years after exposure to the virus.

The new guidelines say women 30 and older who have three consecutive Pap tests that were normal, and who have no history of seriously abnormal findings, can stretch the interval between screenings to three years.

In addition, women who have a total hysterectomy (which removes the uterus and cervix) for a noncancerous condition, and who had no severe abnormalities on previous Pap tests, can quit having the tests entirely.

The guidelines also say that women can stop having Pap tests between 65 and 70 if they have three or more negative tests in a row and no abnormal test results in the last 10 years.

The changes do not apply to women with certain health problems that could make them more prone to aggressive cervical cancer, including H.I.V. infection or having an organ transplant or other condition that would lead to a suppressed immune system.

It is by no means clear that doctors or patients will follow the new guidelines. Medical groups, including the American Cancer Society, have been suggesting for years that women with repeated normal Pap tests could begin to have the test less frequently, but many have gone on to have them year after year anyway.

Debbie Saslow, director of breast and gynecologic cancer for the American Cancer Society ... said, doctors in this country have been performing 15 million Pap tests a year to look for cervical cancer in women who have no cervix, because they have had hysterectomies.

Dr. Carol L. Brown, a gynecologic oncologist and surgeon at Memorial Sloan-Kettering Cancer Center, said the new guidelines should probably not be applied to all women, because there are some girls who begin having sex at 12 or 13 and may be prone to develop cervical cancer at an early age.

“I’m concerned that whenever you send a message out to the public to do less, the most vulnerable people at highest risk might take the message and not get screened at all,” Dr. Brown said.

Dr. Kevin M. Holcomb, an associate professor of clinical obstetrics and gynecology at NewYork-Presbyterian/Weill Cornell hospital, said that when he heard the advice to delay Pap testing until 21, “My emotional response is ‘Wow, that seems dangerous,’ and yet I know the chances of an adolescent getting cervical cancer are really low.”

Denialism: The Mammogram Firestorm Shows How Hard It Will Be To "reduce costs, by using science-based protocols to minimize unnecessary procedures and tests"

An amazing report from the NY Times that can be summarized as: the politicians in Washington intend to use public opinion polls to determine medical policy, not objective, rational science (read Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives).

The Obama administration distanced itself Wednesday from new standards on breast cancer screening that were recommended this week by a federally appointed task force, saying government insurance programs would continue to cover routine mammograms for women starting at age 40.

As the task force recommendations stirred concern among women, and came under fire from lawmakers of both parties, the White House emphasized that they were not binding on either physicians or insurers. Administration officials also fired back against Republicans who argued that the recommendations illustrated the dangers of an expanded government role in medical decision making.

Democrats on Capitol Hill acknowledged that the recommendations, in the midst of negotiations over a health care overhaul, had handed Republicans a vivid new way to raise the specter of rationing.

The issue underscored the political sensitivity of revamping the health care system, and trying to reduce costs, by using science-based protocols to minimize unnecessary procedures and tests. Even as the White House tried to reassure women that the recommendations would have no immediate force, a group of doctors that analyzes new research for the National Cancer Institute said it would include the new guidelines in the information it provides to doctors and the public.

Kathleen Sebelius, the secretary of health and human services, acknowledged in a statement that the recommendations, by the U.S. Preventive Services Task Force, had “caused a great deal of confusion and worry.” Ms. Sebelius then stressed that the task force “is an outside independent panel of doctors and scientists who make recommendations” and who neither “set federal policy” nor “determine what services are covered by the federal government.”

“The task force has presented some new evidence for consideration,” she added, “but our policies remain unchanged. Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action.”

On the White House blog, Dan Pfeiffer, the deputy communications director, wrote that “women who are currently getting mammograms under Medicare will continue to be able to get them.”

“There are no plans to change that,” Mr. Pfeiffer said ...

Neither Ms. Sebelius nor Mr. Pfeiffer explained why the government would not embrace the recommendations from the task force, which is appointed by Ms. Sebelius’s department. She said only that “there has been debate in this country for years” about the proper age and interval for breast cancer screening.

The task force advised on Monday that most women should not start routine screening until they are 50, as opposed to the current standard of 40. The reason, according to the task force, is that studies show that “the additional benefit gained by starting screening at age 40 years rather than at age 50 years is small, and that moderate harms from screening remain at any age.”

While the downsides of mammography have not received much attention, cancer researchers say they are real and include excess biopsies, unnecessary anxiety and the discovery and treatment of tumors that would not cause problems if let alone.

Denialism & The Mammogram Debate: To Ignore Science & Go With Your Preconceived Biases, Or Not

I'm in the process of reading the excellent new book by Michael Specter Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives and will have more on it later. The reaction to the recent scientific panel's pronouncement no longer recommending mammograms to women under 40, nor self-exams to any woman, as reported by the Wash Post below, is, however, a near perfect proof of Specter's argument: far too many people only support scientific conclusions that suit their preconceived biases while rejecting those that don't.

In 1997, a federal committee of medical experts recommended against routine mammograms for women in their 40s, sparking a political uproar that led to congressional hearings and a unanimous Senate vote challenging the findings.

Now, 12 years later, a similar drama is playing out around a different federal medical panel, which this week recommended against routine mammograms for women younger than 50, saying it is not worth subjecting some patients to unnecessary biopsies, radiation and stress.

The independent panel, the U.S. Preventive Services Task Force, also recommended against teaching women to do regular self-exams and concluded that there is insufficient evidence to recommend that doctors do exams.

The findings underscore a decades-long debate in the medical community about the benefits and risks of routine breast cancer screening for younger women. The conclusions also plunge the nonpartisan, nonpolitical advisory panel into the middle of a strident Washington discussion about health care, which has included allegations from Republicans that the Democrats' proposed reforms would lead to reduced care for patients.

Rep. Frank Pallone Jr. (D-N.J.) announced Tuesday that his House health subcommittee will hold hearings on the mammogram issue next month. Other lawmakers from both parties suggested that the task force had been swayed by insurance companies that stand to save money if fewer screenings are performed.

"We can't allow the insurance industry to continue to drive health-care decisions," said Rep. Debbie Wasserman Schultz (D-Fla.), who said earlier this year that she had undergone treatment for breast cancer.

The recommendations also garnered harsh criticism from powerful medical groups including the American Cancer Society -- which says it will continue to recommend regular mammograms for women older than 40 -- and the Access to Medical Imaging Coalition, which warned that the findings would "turn back the clock on the war on breast cancer."

Many patient advocacy groups and breast cancer experts, however, praised the decision, arguing that politics have too often interfered with science when it comes to mammograms. Maryann Napoli, associate director of the Center for Medical Consumers, said breast cancer screening is frequently "used by politicians as a way to say they are for women," whether or not the underlying policy makes sense.