Paul Goldberg reports (subscription or day pass required for full content) :
"In recent weeks, several prominent scientists and public health experts attempted to explain to Rep. Debbie Wasserman Schultz (D-Fla.) and Sen. Amy Klobuchar (D-Minn.) that their bill to introduce breast cancer screening in junior high school could do more harm than good.
These experts included the chief physician of the American Cancer Society, an NIH cancer prevention expert, and a prominent breast cancer epidemiologist, who attempted to acquaint these lawmakers and their staff members with the fundamentals of epidemiology.
Now it seems all that education failed to stick. ...
"There are two sides to this story, and what is presented is that this is something wonderful for women, no downsides," said Leslie Bernstein, a breast cancer epidemiologist and director for cancer etiology and dean for faculty development at City of Hope. "What is missing is presentation of evidence that it will also produce some harm. We don't have evidence to support doing breast self-examination, nor do we have an evidence basis that changing risk factors at a young age will alter young women's risk of breast cancer."
Bernstein was one of the scientists who attempted to present Epidemiology 101 to members of Klobuchar's and Wasserman Schultz's staff. Barnett Kramer, director of the NIH Office of Disease Prevention, similarly made a teaching stopover in the offices of the two legislators.
"I gave them fundamentals of issues concerning screening and talked about the specific principles as they relate to breast self-examination and the available evidence from randomized trials," Kramer said in an interview. "No screening test can have benefits unless it's linked to a subsequent intervention, and all therapies can have harms. In breast cancer, harms have to be explicitly understood." NIH has taken no position on the legislation.
Goldberg also reports that the American Cancer Society does not support the legislation - and why. "Unfortunately the bill as introduced is a public health bill that does not recognize public health as a legitimate scientific discipline," ACS president Dr. Otis Brawley wrote to ACS volunteers.