Is Screening Useless?
Posted 7/16/2012
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This is an extremely interesting and controversial summary of the data and thinking about the value of mammograms and screening in the healthy population. Note that mammograms for women with a personal history of breast cancer are not part of this argument. The author's contention is that mammograms and screening have two primary goals: to increase survival and to reduce the incidence of necessary mastectomies. In both cases, the thinking is that finding breast cancer early will make these improvements possible. Her conclusion (rather shocking) is that mammograms do neither thing, and that there is a strong need to rethink their widespread use.
Here is the abstract and a link. I strongly urge you to read it and, if you would like, please share your opinion with me. Our comment section is still not functioning, so email me: hhill@bidmc.harvard.edu.
Is the tide turning against breast screening?
Karsten Juhl Jørgensen
Abstract
Herein I argue that mammographic screening has not delivered on its fundamental premise: to reduce the incidence of advanced breast cancer. Indeed, achieving this goal is required if screening is to reduce breast cancer mortality or mastectomy use. Rather, screening has caused substantial increases in the incidence of in situ and early invasive cancers. Moreover, evidence indicates that these screen-detected cancers are unlikely to be cases that were 'caught early', but instead represent women who would not have been diagnosed in the absence of screening and who, as a result, have received harmful, unnecessary treatment. If true, these observations raise the specter that screening creates breast cancer patients and that this practice carries little or no benefit.
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