Reply #22: Tell us about the true prevention and better screening tools

[bluedawg12]

I did ask you some questions about your previous statement that were of interest.

What is TRUE prevention?
What are better screening tools.

You never replied.

I consider this a serious matter, if you have those answers, please provide.

>>Mammograms in all age groups are a very poor screening tool. About 5 percent of mammograms are abnormal or suspicious, and of these 80 to 93 percent are false positives that cause unnecessary anxiety and further procedures, including surgery. If that were not enough to question the reliability of mammograms as a diagnostic tool, consider the unfounded reassurance that results from the false negatives that occur in 10 to 15 percent of women whoalready have breast cancer that will manifest clinically within one year.<<

Is this your opinion? Please cite where these statistics come from?

>>In the October 2001 issue of The Lancet, the Nordic Cochrane Centre of Denmark...<<

Your citation about Lancet does not sound like it is from the Lancet article. Is it?
It appears to be from another derivative news source. Again, where is the link? Who are the authors?
This is not from the Cochran report, nor is it even the latest Cochrane report. It’s out of date.

As I mentioned before in my reply:

“However, as with most things in medicine, I can also find you one from the year before that says it’s unproven. There are no cook book answers.- bluedawg12"

...........

http://www.webmd.com/news/20000106/report-calls-mammography-screening-unjustified

Report Calls Mammography Screening 'Unjustified'
By Daniel J. DeNoon
WebMD Health NewsJan. 6, 2000 (Atlanta) -- The scientific evidence that says women should get regular mammograms is flawed, concludes a hotly debated new report appearing in the current issue of The Lancet. Of the eight clinical studies of mammography screening -- in which a half-million women took part -- the report advises doctors to ignore six "biased" studies and to focus on two trials it says show no benefit for screening.

"We feel that the effect of mammography has not been proved," co-author Peter C. Gøtzsche, MD, tells WebMD. "The two well-done trials did not find any effect, even a trend. We do not say mammography is without effect, we say we could not see an effect. If there is an effect of mammography it is likely to be much smaller than we had previously thought."

The American Cancer Society takes strong exception to these conclusions. In an interview to provide objective comment, ACS chief medical officer Harmon Eyre, MD, dismisses the new data analysis in no uncertain terms. "The ACS continues to recommend that women get regular mammograms," Eyre says. "The most important person to get that done is the physician. We believe that by recommending regular mammograms, U.S. physicians have dramatically reduced breast-cancer mortality. We see no reason for them to stop doing so."

But Gøtzsche, director of the Nordic Cochrane Center in Copenhagen, Denmark, stands by the report. "My personal opinion is that if a woman turned to me for advice and asked me if she should join a mammography screening program, with examinations every second year, I would advise her not to do so," he says.

Eyre could not disagree more. "The American Cancer Society very strongly believes that mammography reduces the mortality rate from breast cancer and that the evidence is incredibly strong in the U.S.," he says. "The paper is arguing they haven't seen the same drop in breast-cancer death rates in other countries that is seen in the U.S., but no other country is doing as frequently or as well as we do it in the U.S."

In an editorial also published in TheLancet, Harry J. de Koning, MD, PhD, from Erasmus University in the Netherlands, suggests that the report is too quick to reject the six trials seen as flawed. "In seven of the eight trials there was clearly a benefit for women age 50 and older," de Koning tells WebMD. "I'm still pretty much convinced that most of the trials were run quite adequately."

Gøtzsche and Ole Olsen reanalyzed the mammography studies when they learned that Sweden 's breast-cancer mortality rate did not decrease since mammography screening began in 1985. Six of the trials, they found, did not properly assign women to the study groups that either got or did not get mammograms.

Report Calls Mammography Screening 'Unjustified'
(continued)
continued...
Gøtzsche and Olsen found that two of the trials, one conducted in Canada and one in Malmö, Sweden, had no serious methodological errors. "We rely on the two trials that did produce comparable groups, because that is the point of randomizing hundreds of thousands of women," Gøtzsche says. "We relied on the two best trials, and that showed no effect of mammography on mortality."

The original results from the Malmö study, which Gøtzsche and Olsen endorse, found no mortality benefit from mammography screening. But Koning points out that updated results published in 1995 indeed show a 26% reduction in breast-cancer mortality for women age 55-69 years who were screened.

Koning also criticizes the Gøtzsche and Olsen analysis for failing to take women's ages into account. "We know from breast cancer screening that it is different for premenopausal vs. postmenopausal women," he says. "One major issue is that with breast cancer screening you have to look at mammograms, and with premenopausal women it is more difficult to detect cancers earlier. There is a real biological difference between these women."

Eyre notes that the authors' focus on randomized trials fails to take into account the vast U.S. experience with mammography screening. "In the U.S. in the 1980s, only 13% of women were getting mammograms and average breast tumor size was 3.2 cm in diameter," he says. "In the late 1990s, when about 75% of U.S. women had a mammography, 60% regularly, average tumor size dropped to 2 cm. ... The death rate from breast cancer has dropped 10 consecutive years. All of these things have happened in large part due to American women receiving mammography. The evidence in favor of mammography is very, very strong."