Let Scientists Bicker Over Breast Cancer, Don’t Keep Putting Your Health Last

By Susan Nielsen (OPINION)
The Oregonian, Portland, Ore.

Don’t be alarmed by the latest infighting among doctors and researchers about the value of mammograms in beating breast cancer. The conflicting studies and arguments are signs of a good scientific debate.

Yet this healthy debate could have an unhealthy local impact. More women in Oregon might decide to do nothing, and skip cancer screening altogether, in the face of dissonant medical advice. This is a distressing thought, given Oregon’s higher-than-average rates of breast cancer and its existing barriers to universal screening.

And let’s face it: Most of us are pretty good at neglecting our health without outside help.

This month, authors of a big new study in the British Medical Journal asserted that mammograms have limited value at saving lives and can lead to over-treatment. These assertions infuriated the radiology community, which questioned the study’s validity and re-iterated support for regular screening. One of the study’s co-authors then cast aspersions on radiologists for having a bias in favor of excess testing. (I stopped listening before they started insulting each other’s medical colleges.)

Meanwhile, advocates bemoaned the negative effect of an anti-screening message.

“I think it will have an impact. And I think it does add to the confusion,” said Gail Brownmiller, director of community programs for Susan G. Komen’s Oregon and Southwest Washington affiliate.

The barriers to getting a mammogram, she added, are already substantial. “There are many reasons women put it off. Fear is one. Time, cultural differences, language barriers, they all contribute.”

A mammogram is an X-ray used to detect abnormalities in breast tissue. It is more fun than a colonoscopy but less fun than most other chores that define middle age. It’s also scarier than it should be: Heart disease kills a lot more women than breast cancer, yet breast cancer is the Big One that women worry about most. (In fact, women in their 40s overestimate their nearer-term risk of dying of breast cancer by about 20-fold, according to a study published in the Journal of the National Cancer Institute.)

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