CNN takes advocacy stance in its one-sided view of USPSTF breast screening recommendations

| 7 Comments

Not only did Dr. Sanjay Gupta of CNN show his imbalanced perspective on the US Preventive Services Task Force breast screening recommendation. But CNN's non-physician medical correspondent, Elizabeth Cohen, also offered her opinion on the air.

She said:

"This task force is the only big group that is saying this. There are lots of groups that disagree with this. So for me, a woman in her 40s who has to make this decision, I look at it this way. I say, alright, government task force says I don't necessarily need a mammogram. On the other hand, the American College of Obstetrics and Gynecologists says I should get one. The American Society for Clinical Oncology says I should get one. The American Cancer Society (a chuckle and smirk now appear in her voice and on her voice) say I should get one. I think you can see how that decision - how that weighs out."

No, Elizabeth, I don't see from what you cited how that decision should play out.

Because you haven't explained any evidence to me.

You haven't explained the need for shared decision-making between informed patients and their health care providers.

You've merely drawn a red state/blue state map for me - except that your map was incomplete. What do you mean by "big group"? Do you mean the organizations with big PR machines that usually spin their stories through you?

Because the National Breast Cancer Coalition, Breast Cancer Action, and the National Women's Health Network are among the "little groups" - as you must define them - who support the US Preventive Services Task Force recommendations.

CNN, what have you done to educate viewers on this issue?

What have you done to explain the data?

And why should I care about what Elizabeth Cohen decides?

Why should I care any more about her decision than about the story of women who regret that they ever were screened? (A story she chose not to tell.)

You can hear what Cohen said and how she said it in the clip below from Newsy.com.

You'll also see the comments from Fox News' "Dr. Manny." Perhaps CNN has achieved its goal. In an attempt to catch Fox News in the ratings, it has become just like Fox News.

7 Comments

I think the "drama" associated with this guideline update is based on the fact that the USPSTF is not changing its recommendations because of new data, but making a judgment call after analyzing existing data. In essence, this is what it boils down to IMO:

"The USPSTF decided that screening 1,300 women to save one life is an acceptable cost but screening 1,900 to save a life is not."

For a great analysis of the science, people should check out David Gorski's post at Science-Based Medicine:

http://www.sciencebasedmedicine.org/?p=1926

And personal stories will always trump evidence in consumer land - that's why Jenny McCarthy has been successful in bringing back the Measles. :) Science-based approaches will have to find a way to use the story vehicle to improve our reach. Not sure how best to do that.

Yours in the struggle...

Val

Research by the Nordic Cochrane Centre in Denmark raised questions about the effectiveness of mammography. In a study of 2000 women, they found that one woman would have her life prolonged but 10 would undergo unnecessary treatment and 200 women would experience unnecessary anxiety because of false positive results. According to the authors of the study, it is "not clear whether screening does more good than harm."

One retired oncologist noted that many years ago, the National Cancer Institute tried to convince everyone not to screen women younger than 50 and were given such a tongue lashing by Congress that they went home, licking their wounds, and withdrew their recommendation.

Likewise, the American Cancer Society also avoids looking clearly at the data and continues to recommend screening for younger women. And the morning papers carried lots of outrage from breast cancer specialists and other doctors who are committed to screening younger women.

Some of the reasons for this are political and financial.

It is important to note that companies like General Electric and DuPont, both which manufacture mammography equipment, are large donors to organizations that are against any change in the recommendations.

The President's office did not want to upset constituents. Health and Human Services Secretary Kathleen Sebelius told American women they they have nothing to learn from the science that led to the USPSTF.

I wonder why this has to be so controversial, or to be reported that way. Other countries in the developed world have changed their policies on mammograms years ago. For example, European women women start getting mammograms later than American women, and have them less often. Yet, the health outcomes are not worse. Good reporting is available from BBC online and other foreign media. Better to lookthere than on American TV. America is so backward in this regard - so thank you for your excellent site. At least there is hope that network "news" won't get the last word on this!!

Gary

here is something for you from a different angle.

I saw the clip you attached and I have to addmit that for me as a 45 year young woman - Elizabeth Cohen did a good job.

Look, I am not as smart as you or all the experts that spend hours/days/years in research, develppoment of the latest health concepts and treatments.
I only want to be there for my kids. We have a strategy in place. Next thing I know there is this USP.. and changes the game.

As a news consumer i am looking for someone to make sense to me without listening to more experts that shoot themslef in the foot in this complex subject. I also do not have time or capacity to read and understand all the smart science bloggers.

here comes Elizabeth Cohen and comes with an argument that makes sense to me.

...convince all the other smart organization first and than change years of practice.

i like it

do not find fox or abc (or your post) as helpfull.

thanks

Ann


Steven Pearlstein's well reasoned article in the WaPo.
http://www.washingtonpost.com/wp-dyn/content/article/2009/11/19/AR2009111904053.html

As a breast radiologist working in the United Kingdom, I find the whole furore a little difficult to understand - we have always screened from age 50 unless there is an increased risk due to strong family history to suggest earlier entry. This age was chosen form the evidence from all the European trials. USA has always been out of line with the rest of the world advocating annual mammography from age 40, but from my understanding as an outsider, it is only those with health insurance who benefit from this policy.
I feel much of the opinion is financially based, without looking at the evidence fully. I support the view that mammography should start at age 50, and be performed no more frequently than every 2 years.

Shame on Sebelius! She trashed her own task force, the USPSTF, and missed a great chance to show the country how comparative effectiveness research is supposed to work. The USPSTF bases its recommendations on science and evidence, which is more than I can say for Sebelius. See www.MDWhistleblower.blogspot.com

About this Entry

This page contains a single entry by Gary Schwitzer published on November 19, 2009 7:30 AM.

Call for NIH to fund research on ethics, conflicts of interest was the previous entry in this blog.

In mammography discussion, the plural of anecdote is not data is the next entry in this blog.

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