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Mingle & mammograms parties – more incomplete info promoting screening

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Some weeks like this one just unfold – recurring themes just roll your way whether you’re looking for them or not.

I was not looking for imbalanced screening test promotions when this week began, but I’ve certainly had a number cross my desk.

I just learned of a St. Paul Pioneer Press story that promoted the fact that “Regina Medical Center’s ‘Mingle & Mammograms’ parties offer food, drink and spa treatments to ease the fears and discomfort associated with the procedure, and to encourage women to get screened every year.”

It’s hospital marketing. And the story quotes several hospital marketing people. So it’s hospital marketing through the newspaper – unpaid for.

The story nods – briefly – in the direction of a discussion of evidence, when it states:

The U.S. Preventive Services Task Force, made up of a panel of independent medical experts, recommends breast cancer screening every other year for women ages 50 to 74. It also recommends screening for younger women with family histories of breast cancer or other concerns.

But the American Cancer Society recommends mammograms much sooner. Its mammogram guidelines suggest all women 40 and older should have such a breast X-ray exam once a year. It also suggests women at high risk for breast cancer should start getting mammograms even sooner, or more often.

But that’s it.

Why did the USPSTF make that recommendation?

Why did the ACS disagree?

Isn’t it the job of journalism – and of health care providers – to help women understand these vital evidence-based questions? Isn’t it the job of journalism to help women understand that there are both benefits and harms that can occur?

Or is it the job of journalism to just tell hospital marketing stories?

Here’s one of the medical center’s promotional posters, with no hint of a discussion of the tradeoffs involved in breast cancer screening – especially for women in their 40s.

mingle and mammograms.jpg

What is the quality of the discussion of tradeoffs that takes place at these events?

How much – if any – discussion takes place about what many women view as potential harms of screening?

Yesterday in Washington, I met a nurse practitioner who has written about how she will not have mammograms anymore, a decision made even after she entered a high risk group when her sister was diagnosed with and died from breast cancer.

There are intelligent, informed people who say “no” to screening. You’d never know it from the news story we mentioned. And you probably won’t meet them at such “mingle & mammograms” parties. But people need complete, accurate and balanced information in order to make a choice. Not just a party atmosphere.

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Comments (8)

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Elaine Schattner, MD

January 29, 2011 at 8:57 am

Gary,
I agree the invite is ridiculous.
My issue is with the NP who forgoes mammograms – despite high risk – and your subtle (or not) highlighting (lauding?) of her decision to forgo preventive health care. The sort of motivation she describes is based in fear of finding cancer which, while understandable, was the sort of non-reasoning that kept women out of doctors’ and surgeons’ offices years ago. Around 1920, the 5-year survival rate for breast cancer was under 15 percent for all cases. Today, journalists’ anti-mammography mongering harms patients by giving them pseudo-reasons not to get appropriate care.

Gary Schwitzer

January 31, 2011 at 12:43 pm

The nurse practitioner is an intelligent, informed health care consumer. She knows the evidence, evaluated the evidence, weighed the tradeoffs and made her choice.
We clearly disagree on how much of journalism has handled mammography coverage.
You write about “journalists’ anti-mammography mongering.”
I have shown – repeatedly – how often stories fail to discuss any potential harms of this and other screening tests.
I don’t think journalism should (just as I don’t think doctors should) discourage screening. But I do call for accurate, balanced and complete information on mammography – and on other forms of screening – to help people make informed choices.

Susan FItzgerald

January 31, 2011 at 12:45 pm

Ha – the girls in this flyer don’t look anything like the alleged target audience of 40-somethings, that’s the first thing that strikes me. They make it sound like a lingerie party. Very distasteful, and disheartening to see a hospital flout the new guidelines in order to get customers in the door.
And very discouraging to see newspapers run a news release with scarcely a qualifier. Hardly the “fear-mongering” mentioned by Dr. Schattner.

Gayle Sulik

January 31, 2011 at 3:22 pm

Thank you for this, as well as for the other analyses of the media’s potential role in helping to disseminate evidence-based health information. Unfortunately, even official medical information amplifies the benefits of mammography while minimizing or omitting the risks. A 2006 survey of the content of information given to women who were invited for mammography screening in six countries concluded that “one-sided propaganda about breast screening…resulted in misconceptions about its effects” by Jorgensen & Gøtzsche. The information did not mention the risks of overdiagnosis and overtreatment of healthy women at all. One third of the invitations stated that screening leads to either less invasive surgery or simpler treatment, even though overdiagnosis produces the opposite effect. Half of the invitations mentioned the possibility of pain, a temporary and the least serious harmful effect of screening. Although the researchers produced an evidence-based leaflet that outlined the benefits AND risks of screening, a 2009 follow-up showed little change. The party atmosphere surrounding pink culture…well, that’s another issue altogether in my book.