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Study questions benefit of mammograms in women over 50


3 Star

Study questions benefit of mammograms in women over 50

Our Review Summary

This story reports on the results of a recent observational study from Norway that suggests routine mammograms are not as effective in reducing the risk of death from breast cancer as previously thought. While this story did a nice job of explaining the study and provided useful details about the participants, it failed to meet many of our criteria and missed the important issues. There was no discussion of the cost, harms associated with mammograms and overtreatment, or screening alternatives. In addition, the story could have better explained the study methods and described the results in absolute terms to give them clearer meaning.

Clumsily, the online story also offers a "click to play" video as a sidebar – but it’s about an entirely different study – of mammography in women in their 30s.  The piece is apparently more than 4 months old, yet the voice over in the piece still refers to it as "a new study" – thereby probably confusing many viewers.  It sure confused us. 

CNN just didn’t seem to have its heart in this story.


Why This Matters

The debate regarding mammograms is complex and this story oversimplified the results of the study and failed to touch on many of the important issues. For example, false positive results on a mammogram can cause undue stress and anxiety and serious adverse effects can results from unnecessarily treating breast cancer with chemotherapy, surgery, or radiation therapy. Most importantly, this story failed to frame the study results as an opportunity for women to make an informed decision to receive routine mammograms based on the risks and benefits.  


Does the story adequately discuss the costs of the intervention?

Not Satisfactory
There is no mention of the cost or insurance coverage for mammograms – which is missing a major issue with this topic.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory
The story only gives the results in terms of relative risk, but it would be more meaningful had it framed the results as Dr. H. Gilbert Welch did in the accompanying editorial in the New England Journal of Medicine: “The number of women who will not die from breast cancer rises from 995.6 to 996 per 1000 women with the addition of screening mammography.” In his editorial, Dr. Welsh also presents the Number Needed to Treat (NNT) to explain the results. In this case, 2,500 women will need to be screened to prevent 1 death from breast cancer.   

One of the strengths of the competing WebMD story was its use of quotes and stats from the accompanying editorial.  This story didn’t even acknowledge that there was an editorial.  We don’t understand how that could be overlooked.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory
This story failed to note the potential harms of mammograms, including the emotional implications of false-positive results and the potential adverse effects from unneeded treatments, such as radiation therapy, surgery, and chemotherapy.

Does the story seem to grasp the quality of the evidence?

This story does a good job of describing the methods of the study, including the different groups and the number of participants. However, more information on the average age and relatively short follow-up time of this study would have been helpful. 

Does the story commit disease-mongering?


The story does not exaggerate the prevalence or seriousness of breast cancer. 

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory
This story did not include quotes from any independent sources. Patients and healthcare providers alike are deeply divided on this issue and providing additional perspectives on this issue would have helped readers.

Does the story compare the new approach with existing alternatives?

Not Satisfactory
This story does not mention that women may choose to forego mammography screening. The story briefly mentions “breast cancer awareness,” which suggests the ability to recognize symptoms of breast cancer. Although also controversial, breast self-exams or physical exams by a clinician are possible screening alternatives. 

Does the story establish the availability of the treatment/test/product/procedure?

The availability of mammograms is not in question. 

Does the story establish the true novelty of the approach?

Clearly mammograms are not a new diagnostic tool, but the story does point out that the findings from this recent study suggest lower benefits for reducing mortality than U.S. trials have previously reported.

Does the story appear to rely solely or largely on a news release?

This piece does not rely solely on a press release.

Total Score: 5 of 10 Satisfactory


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