In a system drowning in costs, and at enormous expense, we have systematically ignored virtually identical data challenging the effectiveness of cardiac stents, robot surgeries, prostate cancer screening, back operations, countless prescription medicines, and more. . . .
Why are taxpayers, insurers, the government, and patients having, and paying for, needless procedures like mammograms? Read on to discover the sad truth--
Ignoring the Science on Mammograms - NYTimes.com: " . . .
The New England Journal of Medicine published a study with the potential to change both medical practice and public consciousness about mammograms.
Published on Thanksgiving Day, the research examined more than 30 years of United States health statistics to determine, through observation,
if screening mammography has reduced breast cancer deaths. . . . The results of more than a decade of follow-up on such studies, published more than 10 years ago, show that women in the mammogram group were just as likely to die as women in the no-mammogram group. The women having mammograms were, however, more likely to be treated for cancer and have surgeries like a mastectomy. (Some of the studies include trials from
Norway, the
Netherlands,
Sweden, and
this major review of the data.)
In other words, mammograms increased diagnoses and surgeries, but didn’t save lives—exactly what the researchers behind last week’s observational study concluded.
It is affirming to see this newest study. But it raises
an awkward question: why would a major medical journal publish an observational study about the effects of screening mammography years after randomized trials have answered the question? Perhaps it is because
many doctors and patients continue to ignore the science on mammograms.
For years now, doctors like myself have known that screening mammography doesn’t save lives, or else saves so few that the harms far outweigh the benefits. Neither I nor my colleagues have a crystal ball, and we are not smarter than others who have looked at this issue. We simply read the results of the many mammography trials that have been conducted over the years. But the trial results were unpopular and did not fit with a broadly accepted ideology—early detection—which has, ironically, failed (ovarian, prostate cancer) as often as it has succeeded (cervical cancer, perhaps colon cancer).
More bluntly,
the trial results threatened a mammogram economy, a marketplace sustained by invasive therapies to vanquish microscopic clumps of questionable threat, and by an endless parade of procedures and pictures to investigate the falsely positive results that more than half of women endure. And inexplicably, since the publication of these trial results challenging the value of screening mammograms, hundreds of millions of public dollars have been dedicated to ensuring mammogram access, and the test has become a war cry for cancer advocacy. Why? Because experience deludes: radiologists diagnose, surgeons cut, pathologists examine, oncologists treat, and women survive.
Medical authorities, physician and patient groups, and ‘experts’ everywhere ignore science, and instead repeat history. Wishful conviction over scientific rigor; delusion over truth; form over substance.
It is normally troubling to see an observational study posing questions asked and answered by higher science. But in this case the research may help society to emerge from a fog that has clouded not just the approach to data on screening mammography, but also the approach to health care in the United States. . . ."
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