June 13, 2007

Journal article imbalance on mammography's benefits vs. harms

A study in the journal BMC Medicine concludes that scientific articles on mammography screening tend to emphasize the major benefits over its major harms. Not surprisingly, the imbalance is related to the authors' affiliation. In other words, benefits (not harms) were emphasized by authors who worked with screening.

The authors also wrote:

"Overdiagnosis and overtreatment were often downplayed as negligible by authors working with screening, but they are not. Assuming a reduction in breast cancer mortality of about 15%, as estimated in the two most recent systematic reviews, and 30% overdiagnosis as indicated by the randomised trials, screening 2000 women over 10 years would prevent one breast cancer fatality but turn 10 healthy women into cancer patients unnecessarily."

"Scientific articles on mammography screening favour information on the mortality reduction, and prefer to present this as a relative risk reduction rather than an absolute risk reduction. A relative risk reduction appears more impressive, but tends to make lay people, as well as health professionals, overestimate the obtainable benefit. This problem is known from scientific articles in general, and is particularly important in a screening setting as so few will benefit of the total number screened."

Since news stories are often based on journal articles, it is easy to see how easily journalists fall into this pattern of emphasizing benefits and minimizing harms of screening. It's a journalistic trend we've reported, and it's one that does not serve the public well.

Posted by schwitz at June 13, 2007 06:39 AM | TrackBack
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