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Swedish mammography study sows more confusion about screening for breast cancer

Rating

5 Star

Swedish mammography study sows more confusion about screening for breast cancer

Our Review Summary

This story about a study of mammography in Swedish women in their 40s puts the findings in the context of other recent reports and highlights the critiques of independent experts, thus helping readers to see that this is just one more piece of the puzzle. By including the number of women that needed to be screened in order to prevent one breast cancer death, the story gives readers a more realistic perspective on the percentage difference in death rates the researchers saw between areas that screened younger women and those that did not.

 

Why This Matters

A percentage difference that sounds dramatic may look much different when put into the context of the baseline risk and the potential drawbacks of an intervention.

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story only said once that "the costs are high" referring to screening and the risks of false positives and invasive procedures associated with them.  We look for a bit more detail than that.  But because it was the only story we reviewed that even mentioned costs, and becasue it reported that even this study indicates that over a thousand women would need to be screened for a decade to make a difference for one, we give it a satisfactory score.

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

Satisfactory

This story reports not only the percentage difference in breast cancer deaths between the regions where women were routinely screened and where they weren’t, it also gives readers the total number of deaths and it highlights the finding that about 1250 women would need to be screened for a decade to prevent one breast cancer death.

The story also pointed out that the study did not report true breast cancer mortality rates – meaning how many women diagnosed with breast cancer died of it.

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

Satisfactory

The story notes that screening can lead to false alarms and other adverse outcomes. Although it does not go into detail on the adverse outcomes, it includes comments from independent experts that the study failed to include the harms of screenings as well as the benefits.

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

Satisfactory

The story provides an overview of the key features of this study and includes critiques from independent experts. Indeed, the story highlights concerns about the study design near the top of the story. (It could have done much more on this issue. For example, see our blog post on this matter.)

Does the story commit disease-mongering?

Satisfactory

This story highlights both the total number of deaths reported by the researchers and the number of women who would need to be screened in order to prevent one death, thus putting the risk in perspective.

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

Satisfactory

This story includes critiques of the study design and conclusions, although it does not identify or quote the independent experts, except for one neutral summary quote. (Why are these other critics named?)  Although potential conflicts of interest are not reported, the researchers did not disclose any conflicts in their journal article. We’ll give it a barely satisfactory score, although the unnamed critics issues bothers us.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story does not go into detail about alternatives, but it does highlight a guideline report from the United States Preventive Services Task Force that questions the value of screening mammography for women in their 40s, thereby implying that not being screened is an option.

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

Not Applicable

There was no explicit discussion of mammography, but we can’t criticize the story for that.  Nonetheless, we can only give a score of Not Applicable on this criterion.

Does the story establish the true novelty of the approach?

Satisfactory

The story does a good job of putting this study in context with other reports.

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

Satisfactory

The story does not rely on a news release.

Total Score: 9 of 9 Satisfactory

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