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Mammogram benefits more modest than doctors thought

Rating

4 Star

Mammogram benefits more modest than doctors thought

Our Review Summary

 However, it does not explain to readers what is new or different about this study compared to earlier reports. Also, the final word in the story goes to an expert who touts benefits of mammography screening that clash with what was seen in this study.

 

Why This Matters

By comparing this story with, for example, the Philadelphia Inquirer and WebMD stories, you see how some of the gaps we’ve identified were addressed by competitors, giving readers a more complete and helpful story.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does not mention the cost of mammography (or of follow up tests and treatments) to the individual, or, collectively, to society.  And these costs are substantial.  Based on the results of this study, 2,500 women would have to be screened every other year for a decade in order to prevent one death from breast cancer.

As the story points out, during that same time 1,000 of those women would have at least one false alarm and 500 would undergo an unnecessary biopsy, thus adding to the price tag.

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

Satisfactory

On balance, this story does a fair job of describing the benefits of screening mammography as seen in this study. It reports the apparent 10 percent reduction in breast cancer deaths, while also pointing out that because relatively few women in the 50-69 age group die of breast cancer, that reduction can also be described as cutting the 10-year risk of death from 4.4 per 1,000 women to 4 per 1,000. The second statistic helps counteract popular assumptions about how many middle-aged women die from breast cancer.

However, the framing of a story – and who gets the last word – sometimes overwhelms evidence-based explanations earlier in the story.  That almost happened with this story, which gives the final word to an advocate of annual breast cancer screening for all women beginning by age 40, which is just the sort of blanket recommendation this latest study calls into question.

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

Satisfactory

The story includes a comment that because mammograms detect lumps that would not have become life-threatening, five to 15 women may be treated for every one whose life is saved by treatment.

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

Satisfactory

The story oversimplifies the methods used by researchers, saying they compared “women who were similar in most ways, except that one group received mammograms and the other didn’t,” without explaining that this was not a randomized trial where some women were assigned to screening and others weren’t, but rather an observational study that looked at data on women during a 9-year period when Norway phased in mammography region by region.

The story does alert readers to some of the limitations of the study: one, that a longer follow-up period might have shown more benefit to screening and, two, that the researchers had no information on whether any of the women received mammograms outside of the national screening program.

It’s a tossup for us to grade and, as we do in most such cases, we’ll give the story the benefit of the doubt.

Does the story commit disease-mongering?

Satisfactory

The story does not exaggerate the risk of breast cancer or the need to be screened.

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

Satisfactory

The story includes independent sources. However, it does not tell readers that the study was funded by the Cancer Registry of Norway and the Research Council of Norway.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story never explicitly addresses the option of foregoing mammograms.  Other stories – for example, the WebMD story, did a better job of this.

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

Satisfactory

The availability of mammography is not at issue in this story. The story points out that women in Norway have access to “innovative treatment teams to coordinate a variety of specialty care,” but it does not clearly note that these multidisciplinary teams, while present at many medical centers, are not automatically available to all women in the U.S.

Does the story establish the true novelty of the approach?

Not Satisfactory

This story does not explain what is new or different about this study or what it adds to our understanding of the value of mammography. The key advantage of this study is that it was able to track women over a number of years as screening was rolled out across Norway, enrolling women in some areas of the country before others. The researchers were then able to do a better job isolating the effects of screening from advances in treatment. This was really an important angle that other competing stories – the Philadelphia Inquirer as one example – reported adequately. 

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

Satisfactory

The story does not appear to be based on a news release.

Total Score: 7 of 10 Satisfactory

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