It's a myth that mammograms offer all benefit, no harm

November 20, 2009

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THE US Preventive Services Task Force, not generally known for taking bold or even state-of-the-science positions, is to be commended for its recommendation to limit mammograms to only high-risk women in their 40s and for women age 50 to 74 every two years instead of annually (“Breast screening advice upended,’’ Page A1, Nov. 17).

Those condemning this decision insist on perpetuating the myth of mammography screenings as offering all benefit and no harm. With only 1 in almost 2,000 women in their 40s benefiting from screening mammography and hundreds subjected to unnecessary biopsies and surgeries, this is an exceedingly injudicious use of medical resources, particularly in the middle of a cultural and political donnybrook about unsustainable health care spending.

The shameful behavior in all this is the misleading trading on fear that occurs in the cancer screening industry. Women are led to overestimate their risk of dying from cancer - they’re far more likely to die from heart disease - as well as the benefit from mammography screenings.

Much of what is accurately detected with mammography resides in a gray area of “predisease,’’ much like that found in early-stage prostate cancer. While early-stage prostate cancer is now generally treated conservatively with “watchful waiting,’’ women are falsely led to believe that all cancers need to be treated, even when toxic chemotherapies that cause disease are involved. In short, disease risk is overstated while treatment risk is understated.

We’d all be better served by questioning the absolute risks and benefits of medical procedures and what our screening and treatment alternatives are before agreeing to medical tests and procedures that are often based on slim, if any, evidence.

John Lynch
The writer was founder and president of Medical Diagnostics Inc., a medical imaging firm.

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