DON'T GIVE ME THAT SCIENCE GUFF, I WANT MY MEDICINE!:

Why the new breast cancer screening guidelines make sense (ANDRÉ PICARD, 11/24/11, Globe and Mail

The fundamental problem, aside from failing to recognize that screening carries risks as well as benefits, is the presumption that anyone who has had breast cancer detected by screening has survived because of the test.

That is simply not true.

That's because there are different kinds of breast cancer:

* Slow-growing tumours that would likely be found and treated without screening;

* Aggressive cancers that are deadly, whether they are detected by screening or not;

* Innocuous lesions or growths that are not deadly and frequently result in overdiagnosis and overtreatment;

* Potentially deadly tumours that are detected at just the right time by screening to allow for lifesaving treatment.

The latter group consists of about one in 1,000 women. Do those numbers justify the cost of screening, which is in the neighbourhood of $500-million annually?

Probably - but only if screening is done judiciously, targeting the women who will benefit most and are least likely to be harmed.

That is the 50-to-74 age group. And that is why the task force made its recommendation - not to save money; not because they hate women; not because they are oblivious to the scourge of breast cancer.

No, the recommendations are based on the latest science, not on wishful thinking. The evidence, no matter how displeasing or counterintuitive, must guide us.

And as Dr. Susan Love, the breast cancer pioneer (and supporter of screening over 50), is fond of reminding us: "All too often, when it comes to breast cancer, we seem to get caught up in wishful thinking and forget about science."

Posted by oj at November 25, 2011 5:11 AM
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