Multiple reasons why women are misinformed about breast cancer

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John Crewdson in The Atlantic:

"The current controversy over the task force's report owes much to the media's confusing coverage, some of which has been misinformed, including by TV doctors who ought to know better.


The confusion has been abetted by the American Cancer Society, whose position appeared to have softened, then hardened again, in recent weeks.

There are multiple reasons women are ill-informed about breast cancer. The fault lies primarily with their physicians, the cancer establishment, and the news media--especially the news media. Until coverage of breast cancer rises above the level of scary warnings mixed with heartwarming stories of cancer survivors, women are likely to go on being perplexed."

2 Comments

Women have every right to wonder what to believe, and most journalists aren't up to the task of clarifying what the early-detection study actually says. The challenge for journalists is that the study expresses statistical probabilities: it takes nearly two thousand early screenings of forty-something women to prevent one death from breast cancer. And because those same early screenings produce a lot of false-positive results, too many women are subjected to unnecessary procedures and treatments. Seems like a no-brainer: if you're a woman in your forties, with no obvious risk factors, save yourself a ton of trouble; don't get a mammogram. But how many journalists are prepared to try to explain those dry statistics to their readers/viewers in the face of the resulting confusion, even outrage, over the upending of decades' worth of public policy? And what to do with the fact that most women know someone who they believe is alive today only because she had an early mammogram, or found a lump during a routine self-exam? In today's news environment, it's no surprise that most reporters will opt for the emotional "what if I hadn't gotten that exam?" story. The statistics-based story - if you get an early mammogram, there's a good chance it could scare you into unnecessary treatments - is a very tough sell to women who ask, But what if I'm that one-in-two-thousand?

The reaction by Congress and the public is not new and therefore it was predictable. In 1997 an NIH Consensus Panel issued a statement with the same recommendations: http://www.ncbi.nlm.nih.gov/pubmed/9267441?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=1&log$=relatedreviews&logdbfrom=pubmed

NIH Consens Statement. 1997 Jan 21-23;15(1):1-35.
NIH Consensus Statement. Breast cancer screening for women ages 40-49.

Congress had the same backwards and anti-science reaction as it did this time, and people were as ready to bring out the pitchforks and torches as they are now, especially in the context of this summer's circuses around "health care reform" (which the media were equally happy to mischaracterize).

We need a national teach-in on epidemiology. John Crewdson took a good first stab at it.

About this Entry

This page contains a single entry by Gary Schwitzer published on November 21, 2009 7:00 AM.

Howard Kurtz doesn't add to public understanding of mammography issue was the previous entry in this blog.

10 things that stand out from the mammography week to remember (forget?) is the next entry in this blog.

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