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COPENHAGEN, DENMARK. A large study of the benefits of mammography screening for breast cancer
was carried out in 2001 by the prestigious Cochrane Institute. The study questioned the benefits of
screening and pointed out that screening could be harmful in that it frequently leads to over-diagnosis and
over-treatment. The Cochrane Institute has now released the results of a new study aimed at determining
how fairly the benefits and dangers of mammography are presented on web sites. They evaluated 13 sites
maintained by advocacy groups, 11 maintained by governmental institutions, and 3 maintained by consumer
organizations. They found that all the advocacy group sites accepted sponsorship from industry without
restriction. The close relationship can perhaps best be summed up in this quote from the Canadian Cancer
Society, "Partnership with the Canadian Cancer Society can assist your company in reaching your
commercial objectives."
The researchers found that all the governmental agencies and advocacy groups heavily favoured screening and significantly downplayed the drawbacks; the consumer health organizations took a much more balanced view. The advocates particularly highlighted a 30% reduction in the risk of dying from breast cancer if regular screening takes place. They often failed to mention that this 30% reduction is a relative reduction and not an absolute reduction. Of course, emphasizing a 30% reduction is much more impressive that stating that having mammograms may reduce the risk of dying from breast cancer by 0.1% over a 10-year period. The advocates also downplayed the fact that women having regular mammograms would have a 49% chance of being recalled for a biopsy during a course of 10 mammograms and that mammograms can be painful – so painful in fact that many women refuse a second one.
The researchers conclude that, "The information material provided by professional advocacy groups and
governmental organizations is information poor and severely biased in favour of screening. Few websites
live up to accepted standards for informed consent such as those stated in the General Medical Council's
guidelines." Editor's comment: It is indeed unfortunate that mammography has such a stranglehold on breast cancer detection at least in North America and Western Europe. This virtual monopoly and the enormous industry supported by it is no doubt responsible for the fact that newer, more accurate, less dangerous, and painless techniques such as thermography, scintimammography, nipple secretion analysis, and duct imaging are not given a fair trial.
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