This story summarizes results from a new Dutch study that finds women undergoing screening mammography reduce their risk of dying from breast cancer by 49%. The article does a good job of briefly summarizing some of the debate around the age to begin screening and uses an outside expert who identifies some limitations of the study. However, the article fails to ask the hard questions to help readers with a balanced viewpoint.
We’re not sure that women will be any more clear about the state of the evidence after reading this story. There’s been much debate about the benefit of mammography screening and whether the benefits outweigh the harms. This story does not really help women put the information into context, nor does it help them analyze whether this is news that really matters.
There is no discussion of the costs of mammography.
While making an attempt to quantify benefits, the author frames the information in confusing language that appears to indicate cause and effect: “women who underwent screening reduced the risk of dying from breast cancer by 49 percent.” Mammography is screening, not treatment, and does not prevent or cure breast cancer. Citing the conflicting evidence about the benefits of breast cancer screening would improve the quality of the article. For instance, in two large, randomized clinical trials that looked at the benefits of screening mammography for survival, the Malmo and Canadian trials, the women who chose mammography screening had the same breast cancer mortality or death rate as the women who did not.
The article refers briefly to “overtreatment” but fails to explain this or other potential harms.
This article underplayed the limitations of the original study. Crucial details are absent in this article, such as the way in which the women were “invited” into the study (a term used in the original abstract,) how it was determined the women died of breast cancer, what type of cancer was diagnosed, whether or not there was appropriate treatment, and the effects of lead-time bias,where patients do not live longer but know about their cancer longer.
The story should have emphasized that this was a case-control study and should have explained limitations inherent in such a design, making the story’s causality comments inappropriate.
A statistical reference to the number of women who are diagnosed and die from breast cancer would be useful, but there is no direct evidence of disease-mongering.
Although there is no specific indication of whether or not there is a conflict of interest ,the article is considered satisfactory because it names the source of the study and provides one independent source, Dr. Stephanie Burnik.
There is no discussion of alternatives to “routine mammograms” although the article does mention the debate as to the best schedule and age to begin. The clear alternative is not to be screened.
Not applicable. The study was in the Netherlands, which has a national screening program.
Screening mammography is not a new approach to detecting breast cancer.
This article clearly states it is based on a publication in the journal Cancer Epidemiology, Biomarkers and Prevention Dec. 6,2011.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
Comments (1)
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nancynursez637
December 11, 2011 at 6:28 pmThe literature is all over the place on whether screening is advantageous and at what age. To not screen, embraces a philosophy of “acceptable losses”. those we don’t find in time will just die, but we will have saved a pile of money with reducint screening.
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