August 1, 2012

AESTHETICS, NOT SCIENCE:

In Mammogram Debate, Politics Trounces Science (Handel Reynolds, Jul 31, 2012, Bloomberg)

 In a moment of unprecedented candor for an official of the normally message- disciplined American Cancer Society, Otis Brawley, its chief medical officer, made a startling admission. In a New York Times interview, he said, "I'm admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated." He went on to say that even though mammography can save lives, "if a woman says, 'I don't want it,' I would not think badly of her, but I'd like her to get it."

Brawley was responding to an article that had just been published in the Journal of the American Medical Association, in which researchers argued that 20 years of widespread breast and prostate cancer screening had failed to deliver the promised health benefits. In both cases, screening had led to a huge increase in the incidence of early-stage disease, with only a very slight decrease in late-stage disease. This is significant because the basic rationale for screening has always been that identifying and treating more early-stage cancers will lower the number of late-stage cancers. That this has not happened suggests that screening detects many nonaggressive cancers that would not have progressed if left undetected. The practical result of large-scale screening, in other words, was overdiagnosis and overtreatment.

Posted by at August 1, 2012 5:27 AM
  

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