Breast cancer screening tied to overdiagnosis
The harms of cancer screening are the subject of debate. They can range from anxiety to further invasive and expensive testing and treatment.
The authors of a linked commentary wrote that doctors “have an ethical responsibility to alert women to this phenomenon.”
Dr. Joann Elmore from the University of Washington School of Medicine and Dr. Suzanne Fletcher of Harvard Medical School added, “Most patient-education aids do not even mention overdiagnosis, and most women are not aware of its possibility.”
David Roder, a professor of cancer epidemiology at the University of South Australia and a senior adviser to Cancer Australia, said he disagreed with the methodology of the Monash study and thought it inappropriate to tell women about the possibility of over-diagnosis when the estimates were so imprecise.
‘‘We need to be careful not to spook people into thinking there is no value,’’ he said. ‘‘I don’t know what we’re meant to tell women at the moment, other than there is a chance we’ll find something that may not have materialised in the future.’‘
BreastScreen Victoria’s Vicki Pridmore said those working in breast screening were well aware of the debate, but did not feel the need to talk to women about it in great detail when there was little consensus.
BreastScreen Australia targets women aged 50-69 without symptoms. Women in their 40s and 70s can also attend.
“There’s no right answer here except: tell people the truth,” Welch told Reuters Health.
“Rational women can look at the data on mammography and come to different conclusions. I think there’s a genuine choice here.”
SOURCE: Annals of Internal Medicine, online April 2, 2012.