Are U.S. breasts different?

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My friend Andrew Holtz asked journalists on the Association of Health Care Journalists’ listserv, “Why did this week’s Cochrane review examining the balance of risks and benefits of mammography get widespread coverage in the UK, but almost no mention in the US news media? Of the two dozen stories picked up in a Google News search, almost all were from the UK, Australia and other Commonwealth nations, but there were no U.S. news stories found. The story hasn’t appeared on, or mentioned it only in its international section as part of a world news digest. So the BBC and others had headlines like: “Breast Screening Concerns Raised” and “Researchers question benefits of breast cancer screening.” Meanwhile, US news outlets ran story after story on breast cancer that never mentioned the potential downsides of mammography… with rah-rah leads such as “Mammograms are good” and “No more excuses for not getting mammograms.” It seems British and Australian editors have a different view from those in the US about what sort of info is relevant to their readers and viewers.”

You can read the BBC story as an example of what you didn’t get here. Excerpts:

“They found that for every 2,000 women screened over a decade, one will have her life prolonged, but 10 will have to undergo unnecessary treatment.”

“…The scientists found mammograms did reduce the number of women dying from the disease. But they also discovered it was diagnosing woman with breast cancer who would have survived without treatment, meaning they were undergoing unnecessary chemotherapy, radiotherapy or mastectomies. About a fifth of cancers picked up by screening are in the milk ducts of the breast. Some of these cancers will progress while others will not – but there is no way of predicting what will happen. This means women and doctors have to decide whether or not to risk doing nothing, or go ahead with treatment which might be unnecessary. They also revealed a further 200 women out of every 2,000 experienced distress and anxiety because of false positives – a result that indicated a cancer was present but was later found to be wrong.”

Some journalists responded on the listserv that the Cochrane Library review was just that – a review of past studies – and therefore, not news. Others responded with emotion – not evidence – about a woman’s “need” to, or “right” to, have regular mammograms. (These were supposedly even-handed journalists, mind you.)

Holtz’s observation about British and Australian editors having a different view from those in the US about what sort of info is relevant to their readers and viewers is interesting, and it may reflect an American cultural bias toward more screening and more aggressive treatment, regardless the evidence.

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