Tuesday, October 30, 2012

CANCER SCREENING: BLESSING OR CURSE?


The good news is that breast cancer screening for women over fifty saves lives, an independent panel in Britain has concluded. This confirms other studies, including in the U.S.


The bad news is that for every life saved, roughly three other women were overdiagnosed, meaning they were unnecessarily treated for a cancer that would not have threatened their lives. The study reported that the British program annually saves about thirteen hundred women from dying of breast cancer while about four thousand are overdiagnosed. Overdiagnosis leads to unnecessary treatment such as chemotherapy, surgery and/or radiation for a breast cancer that while present, grows too slowly to be life-threatening.

Commenting on the study, Karsten Jorgensen, a researcher at the Nordic Cochrane Centre in Copenhagen who has previously published papers on overdiagnosis, said, “Cancer charities and public health authorities have been misleading women for the past two decades by giving too rosy a picture of the benefits [of mammograms].”

Maggie Wilcox, a breast cancer survivor and a member of the panel that published the report, said the current information on mammograms given to British women was inadequate. “I went into (screening) blindly without knowing about the possibility of overdiagnosis,” said Wilcox, 70, who had a mastectomy several years ago. “I just thought it's good for you, so you do it.”

So how does one navigate these confusing waters? Ms. Wilcox offers a clue, informed consent. Knowing what she knows now about overtreatment, she says she’d still have chosen to get screened. “But I would have wanted to know enough to make an informed choice for myself.”

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