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David Plaut: Off the Cuff

Mammography Screening, Part 2

Published May 13, 2014 12:45 PM by David Plaut

This is the second of two blogs in which I discuss a response to the Swiss Medical Boards recommendation to stop mammography screening for breast cancer. In a separate essay, two of the members of the committee that wrote the recommendation brought up four aspects of it.

Regarding their third concern, they wrote, “We were disconcerted by the pronounced discrepancy between womens’ perceptions of the benefits of mammography screening and the benefits to be expected in reality. How can women make an informed decision if they overestimate the benefit of mammography so grossly?”

They referred to studies in the US and Switzerland indicating that, when asked about the efficacy of screening, overestimated the outcomes. For example, in one survey about U.S. women's perceptions, in which 717 of 1003 women (72%) said they believed that mammography reduced the risk of breast-cancer deaths by at least half. In reality, “Annual mammography in women aged 40-59 does not reduce mortality from breast cancer beyond that of physical examination or usual care. 0verall, 22% (106/484) of screen detected invasive breast cancers were over-diagnosed, representing one over-diagnosed breast cancer for every 424 women who received screening.” (1)

Lastly, they wrote that “the board therefore recommended that no new systematic mammography screening programs be introduced, and that a time limit be placed on existing programs. In addition, it stipulated that the quality of all forms of mammography screening should be evaluated and that clear and balanced information should be provided to women regarding the benefits and harms of screening.”

References

1.            BMJ 2014; 348 (Published 11 February 2014.

posted by David Plaut

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