CNN's one-sided view of mammography controversy

CNN’s House Call with Dr. Sanjay Gupta once again showed its one-sided, pro-screening bias this weekend. Excerpt:

We’re starting with a change in what’s been standard medical advice for a long time. For years, women over 40 have been told they need routine mammograms. Now the American College of Physicians says women with no risk factors for breast cancer should talk to their doctors first, that perhaps they could postpone their mammogram until they turn 50.

The American Cancer Society says annual mammograms starting at age 40 are still the way to go. You know what? It’s leaving a lot of women wondering who they should believe.

So here to clear things up is Dr. Larry Norton. He’s director of Breast Cancer Programs at Memorial Sloan-Kettering Cancer Center.

Well, Dr. Norton doesn’t accept the College of Physicians’ reasoning, writing them off as “an organization of internists??? – not cancer specialists or surgeons. He said:

“But the fact is that every woman that I speak with would much rather have a needle biopsy, which is not such a big deal, to make sure that the thing that the mammogram finds is not cancer, than actually miss a cancer that could cost her her life, or cost her her breasts.”

OK, but that’s personal anecdote, not evidence. There’s an old saying: the plural of anecdote is not data. One big chunk of evidence he didn’t address is DCIS – or ductal carcinoma in situ – which shows up more often in earlier mammograms and leaves women confused about whether it’s a cancer, or, as it’s often called, pre-malignant or precancerous. And there is no consensus about what to do about DCIS once you find it. Why didn’t he talk about these cases? And why didn’t Gupta ask about them?

And why did Gupta and CNN only give airtime to one side of the argument? The perspective of the American College of Physicians (ACP)– the largest medical specialty organization and the second-largest physician group in the United States, representing 120,000 members – was simply not represented.

The ACP says its “clinical guidelines are developed in an explicit, rigorous process based on extensive review of available scientific evidence. They are considered ‘evidence-based’ rather than “expert-opinion??? or consensus guidelines. In addition to publications from the original mammography trials, ACP reviewed 117 studies to evaluate the evidence about the risks and benefits of mammography screening for women between the ages of 40 and 49.”

Yet CNN didn’t give ACP a voice in this segment, and let its guest get away with saying “We still need to figure out why they made this recommendation.” Why not ask them on the air?

Three times in the segment, Gupta said his guest “cleared up??? the confusion. I guess it’s easy to view something as clear if you only open your mind to what you want to believe.

CNN has shown a pro-screening, evidence-be-damned mentality before. It is not balanced. It is not complete. And it is not journalism. It is advocacy.

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Comments (6)

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April 8, 2007 at 4:38 pm

actually miss a cancer that could cost her her life, or cost her her breasts
Of course, the little fact that there are actually more mastectomies among screened women escapes his notice. Unless, of course one compares percentages instead of totals and ignores the fact that there are more screened women diagnosed.
I don’t believe it is just CNN, though. Fox’ doctor recommended lung CT scans some time ago as well as PSA. Don’t know what he has to say about mammograms – hasn’t watched recently, but I’d be surprised if it is not along the same lines.
I wonder if it is just the ratings. I.e. TV doctors say what TV audience wants to hear.


April 9, 2007 at 12:25 pm

Just to clarify, the first line in my post was a quote from the article no something I said. Not sure why it didn’t appear as such.

John J. Coupal

April 10, 2007 at 8:49 am

The TV mainstream media generally have poorly trained people reporting medical news. If the reporters are physically attractive and passably coherent on-air, management considers that to be sufficient preparation to present complicated medical issues to the masses of people listening and watching.
Until the public demands the two sides to most controversial issues, those “one size fits all” recommendations will continue.