If you’re not at least a little bit confused by current mammography guidelines you’re in the minority. And if you’re an elderly woman (75 and up) or a caregiver for one it can be especially daunting to stay on top of the latest recommendations regarding mammogram screenings in later life.
Policy makers don’t have as much data on this group as they do for younger women. That’s why it’s very important for groups releasing study findings that support or refute existing guidelines for mammograms to apply nuance and address the pros and cons of continued screening.
We recently reviewed a PR news release from Florida Atlantic University that recommended regular mammograms for the elderly and ran with the following headline: “New FAU study suggests benefits of regular mammography extend to the elderly.” Here’s the news release and our review.
We concluded in the review that “The study is observational and doesn’t prove that annual mammograms in elderly women extends life.” But the news release had almost no such tempering language beyond the boilerplate statement that “further research is needed.”
As additional followup, we looked at some of the news coverage of the study that appeared after the release. What we found is that news media relied on the release very heavily, didn’t question the primary message and skipped some other steps that would make the story more useful for readers as they try to stay informed about screenings.
One thing we always look for in releases and stories is a mention of risks to the patient and limitations of the study. Almost all published studies address them.
While the HealthDay story was limited to information found in the news release, the Health Imaging article discussed harms found in the published study. It names unnecessary biopsies and quantifies them: “To measure potential harm from mammography screening, the researchers calculated the percentage of women who received breast biopsies after false-positive diagnoses….The net increase for annual screening was 323 biopsies among the 54,213 women receiving annual or biennial mammography (0.6 percent).”
Health Imaging also quoted some limitations from the study: “We believe the current evidence about potential benefits and harms from screening mammography in this population is insufficient for clinical or policy decisions.” That’s context that was missing from the HealthDay story.
Granted, the Health Imaging audience is likely comprised of professionals who would expect and demand this type of context in their reporting. But we believe that a consumer audience also needs to know when findings are preliminary and there are potential harms from the proposed intervention.
What else could these stories have done better?
“Neither the Health Day or Health Imaging stories included any independent expert opinion,” laments breast surgeon Deanna Attai, MD, assistant clinical professor of surgery at the David Geffen School of Medicine at UCLA, and frequent HealthNewsReview.org contributor. “It seems as if these stories simply reported on the news release.”
We don’t offer medical advice on HealthNewsReview.org but here’s what a trusted breast cancer expert takes into account when recommending screenings for older women:
“My personal opinion for older patients in my practice is similar to the new ACS guidelines,” says Attai. “Screening mammography should be considered if overall health is good and if the patient has an approximately 10 year life expectancy — and I’d add to that — after discussion of the risks and benefits of mammographic screening.”
Update to this post: Attai’s message above needs to be amplified because over-diagnosis is harmful to patients and costly to society. A new study published January 21 in JAMA Oncology claims that almost 16 percent of Americans over age 65 are receiving non-recommended annual prostate and breast cancer screenings. The study by the Henry Ford Health System in Detroit suggests that this is occurring in individuals with a life expectancy of less than 10 years despite guidelines recommending against screening. Further, non-recommended screenings vary by region – from 11.6 percent in Colorado to 20.2 percent in Georgia.
Kathlyn Stone is an associate editor with HealthNewsReview.org.