The Center for Public Integrity has published a thought-provoking piece with the following premise: “There is no evidence digital mammograms improve cancer detection in older women. But thanks to political pressure, Medicare pays 65 percent more for them.”
Excerpts:
“We are living in a time when a lot of medical interventions have been oversold, and [digital mammography] is another one,” said Dr. Russell Harris, a professor and preventive medicine expert at the University of North Carolina School of Medicine. “What’s happened is that the people who make the machines, who benefit by selling newer machines, have triumphed.”
And on that path to triumph, the makers of digital mammography machines had plenty of help. The story behind the rise of digital mammography is a tale of intense industry marketing, direct-to-consumer advertising, political lobbying, and strategic campaign donations to politicians who shepherded beneficial Medicare reimbursement rates through Congress, creating the financial incentive for clinics and hospitals to replace film machines with digital.
In 2009, the U.S. Preventive Services Task Force, which was derided by many radiologists and breast cancer advocates for opposing routine mammograms for women aged 40 to 49, found there is insufficient evidence to assess the benefits or harms of digital mammography, regardless of a woman’s age.
Dr. Ned Calonge, the task force chair, said the group reviewed studies including DMIST and “found no evidence that digital was performing better than plain film” when judged in terms of health outcomes.
The distinction between judging imaging technologies based on patient outcomes rather than cancer detection is not a small one. Mammography proponents have long stressed the role that early detection plays in fighting cancer. But Calonge said it may be untrue that simply finding more cancers earlier equates to improved outcomes for women. It’s not the number of cancers that imaging detects, Calonge said, it’s making sure that they find the correct cancers, adding that all screening tests have benefits and harms.
One of the harms of all mammography tests, Calonge said, is they pick up a certain number of cancers that will never harm a woman, leading to needless biopsies and mastectomies in a certain number of women. He said it remains unclear which test – digital or film – better mitigates those risks. “Rather than embrace the new technology, we need to figure out if it works first,” Calonge said.
You can read GE Healthcare’s response at the end of the story on the Center for Public Integrity website.
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Comments are closed.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like