October 24, 2003
Debate on mammograms
A series of articles published Oct. 15 in the Journal of the National Cancer Institute, including one by a UW professor, highlights an ongoing debate on the risks and rewards of breast cancer screening for women younger than 50.
The articles feature a point/counterpoint discussion between Dr. Alfred Berg, professor and chair of family medicine at the UW, and Dr. Cornelia Baines, professor at the University of Toronto.
Citing a Swedish study, Baines pointed out an increase in breast cancer mortality rates for women age 40 to 49 within seven years of receiving mammograms. Women should be told about this risk, Baines argued, as well as the relatively small long-term benefit of such early breast cancer screenings.
“Women are supposed to be informed before making decisions about screening, but unfortunately, most are ill-informed about both the hazards and the benefits of screening,” Baines wrote in the article.
Berg, writing as chair of the United States Preventive Services Task Force, argued that the increase in cancer mortality from mammograms is not statistically significant or consistently observed.
It’s a good idea to inform women about the detriments of mammograms before age 50, Berg said in the article, as well as the small positive effect the screenings have in the long term. But, he added, there isn’t enough evidence to suggest that physicians should warn women about a possible short-term increase in cancer mortality.
“We agree with Dr. Baines that women need to be informed of the potential benefits and harms of screening, but we would include in the lists of outcomes only those for which we have at least fair quality evidence,” Berg wrote. “An early increase in mortality does not, in our judgment, make the list.”
