US government confused about mammograms
“Women are confused.”
That’s what U.S. Health and Human Services Secretary Tommy Thompson said last week when he announced the government’s new guidelines for mammography use. He meant his words to be reassuring. But it seems to me that Mr. Thompson has only added to the confusion.
You see, thanks to the work of Mr. Thompson’s agency, the U.S. government is now recommending that all women age 40 and older have a mammogram “every year or two.” That’s a step up from the previous guidelines that advised starting regular mammograms at age 50. But here’s the confusing thing: the new recommendations aren’t based on any scientific reasoning – in fact, they fly in the face of mounting evidence that mammograms don’t save lives at ANY age.
The rest of the world is questioning mammography – why is the U.S. still championing the cause?
In the December 18, 2001 e-Alert I wrote to you about the work of two Danish scientists who had concluded that “screening for breast cancer with mammography is unjustified.” Their initial study, released in 2000, drew sharp criticism from the medical mainstream, who has long considered any questioning of mammography as heresy. So the scientists put their data through the ringer a second time – and came out with even stronger results. As they wrote in their commentary in The Lancet, the second analysis “confirmed and strengthened” their previous findings, and, in fact, suggested that mammograms may actually harm women, by leading to dangerous and unnecessary follow-up treatment.
Since then, the Danish studies have caused quite a stir in the medical community. In a recent article on its website, CBS News called the issue “an international uproar.” And in January, the National Cancer Institute (NCI) even admitted that the research raised serious doubts about mammography’s benefits. In fact, according to CBS, the NCI plans to change the information on its website to downplay the importance of mammography in light of the new analysis.
Yet somehow, the U.S. Preventive Services Task Force still was able to come up with these new guidelines, telling millions of American women that they should subject themselves to a mammogram a whole decade earlier than before, and to continue to do so nearly every year. And they say that women are the ones who are confused?
The government’s “final word” means absolutely nothing
Mr. Thompson proclaimed that this is the U.S. government’s “final word” on mammography. But when you peel back the layers, there’s little foundation for such a definitive statement. In the CBS News article, Task Force vice-chair Janet Allan acknowledged, there’s “no firm age at which to start getting them [mammograms].” The Task Force concluded that “the evidence is strongest for women over 50, but mammograms likely will benefit 40-somethings, too.” They can’t prove that an annual mammogram is better than one every other year, or that self-exams, or physical examination by a doctor, save lives either. That’s a lot of soft language and unanswered questions for the “final word” on life-and-death issue.
But there’s another issue here – perhaps an even more important one. Why do we need Tommy Thompson to tell us how often we should get a mammogram? Why should the U.S. government spend millions of taxpayer dollars staffing a “task force” to tell us how we should take care of ourselves?
Thankfully, we haven’t (yet) reached the point where the government health police can arrest us for not having our annual mammogram. It’s still each woman’s choice, based on her individual situation and her own opinion of the information she’s gathered through research and conversations with her doctors. But situations like this make you wonder: When government officials can make blanket proclamations with little scientific backing – and announce them to the world as “the final word” on our health, you have to wonder what the future has in store.
Copyright 1997-2002 by Institute of Health Sciences, L.L.C.
