Fact boxes can quantify the benefits and harms in a clear and accessible format.
When it comes to cancer screening, doctors have “too often” ignored” the fact that women can weigh different pros and cons differently, so all they have to do is convince, rather than educate, and let people form their own opinion. To do that, “they have to a quantification of its benefits and harm ”in a clear and accessible format. Input, “Fact boxes”.
Let’s take an example: in 2014, German doctors recommended transvaginal ultrasound, which involves inserting a probe to millions of women, to look around for ovarian cancer. Is that effective? What does science say Based on a study of hundreds of thousands of women if you randomize A thousand women who get vaginal ultrasounds and a thousand women who skip the screening and then follow it up for a decade or so, three of the women who weren’t screened will die of ovarian cancer, as will the same number of women who got screened . So there was no advantage at all. Instead, 32 of the women screened underwent an operation, and some had their ovaries removed because something looked suspicious on the ultrasound, but it turned out to be completely unnecessary. And one of these women suffered surgical complications – all in vain. Only harms, no benefit, but millions of women have subject the probing “which will likely result in more than 10,000 women having healthy ovaries removed in just one year.” A blessing for the hospitals and the surgeons (and their local BMW dealers), but only pain and suffering for the women.
What would a fact box for mammograms be? search like? I show one at 1:44 in my video The Pros and Cons of Mammograms. As you can see, each gray circle in the graphic represents a woman. Thousands of women were either randomized to skip mammograms or randomized to be screened. After a decade, about five out of every thousand women in the group without screening will die of breast cancer. Even without mammography screening, the chance of dying from breast cancer by the age of 50 is less than 1 percent. However, from regular mammograms, only four in thousand die from breast cancer instead of five in thousand women die from breast cancer, although the total number of women who die with or without screenings appears to be the same. So overall, lives are not necessarily saved. But maybe the studies just didn’t have the statistical power to show an overall survival benefit.
As for the harm, however, hundreds of women who will have a mammogram will be recalled and possibly even biopsied because of false positives, and five will have unnecessary lumpectomies or mastectomies. “A third potential harm, to get Radiation-induced breast cancer from mammography is not taken into account, as only rough indirect estimates (1–5 out of 10,000) exist. “
I show a graph of another study at 2:51 in my video. Researchers examined data from 20 years of age from women the following the current US Task Force for Preventive Services recommends having a check-up every two years from the age of 50. One would expect 200 false positives in those two decades, but only about 30 would end up being biopsied. A few cancers would be missed, but too many would be found in 15 cases, meaning women would be needlessly diagnosed and treated for breast cancer. On the other hand, two breast cancer deaths would be averted thanks to mammograms, although apparently no life would be saved overall.
However, not everyone agrees with these numbers. At 3:28 a.m., in my video, I show the most optimistic numbers I could find per 1,000 women examined. As you can see, it can get up to ten times the benefits for a woman to get Mammograms unnecessary every year for 25 years starting at 40 cancer.
Now that assumes we are talking about asymptomatic women with average risk. It is expected that women at higher risk, such as those who have had breast cancer or have BRCA gene mutations, would benefit much more. For the average woman, “there is simply no ‘right’ answer to whether or not a woman is undergo Mammography screening. ”It should be left to every woman to form her own opinion.
“We to hope that [presenting these] For some women, the data is enough to make a decision about whether or not to be screened. Some may choose to be screened because they see any potential benefits as justifying the accompanying harm. Others may choose not to ”because the potential“ harm is too great to justify the relatively small benefit ”.
Anyway, how about if you try not to? will Breast Cancer First? “Individuals would be better told Doing a rapid test every few years when asked to eat well and exercise to prevent cancer [before it starts]. “Screening is an easy way for both doctor and patient to believe that they are doing something good for their health, but their risk of cancer has not changed at all.” Getting cancer – and this is not only true for cancer. The same diet and lifestyle that it can protection Against cancer can also protect against the leading killer of women. For example, as you can see in my video at 4:56 am, the annual number of women who died of breast cancer from 2006 to 2010 was below 50,000, while the annual number of women who died of heart disease during that period was over 400,000. And while mammograms may not save lives, we know lifestyle changes to prevent heart disease can. Perhaps some of those billions of dollars spent each year on mammography programs could be better spent saving women’s lives.
THE CENTRAL THESES
- Without mammography screening, the chance of dying from breast cancer in your fifties is less than 1 percent. With regular mammograms, four women die from breast cancer instead of about five out of a thousand.
- However, mammograms are associated with myriad damage, including false positives and overdiagnosis that can lead to biopsies, unnecessary lumpectomies or mastectomies, radiation treatments, and chemotherapy, not to mention radiation-induced breast cancer from mammograms and the stress and emotional toll of it all.
- Even if you look at the most optimistic numbers per thousand women surveyed, which shows that a woman who receives an annual mammogram for 25 years from the age of 40 can benefit up to ten times as much, at the cost of an average of three false positives for every woman, a one in three chance of getting a biopsy, and about a 1 percent chance of getting breast cancer diagnosed and unnecessarily treated.
- It is hoped that women will be given all of the data to make informed decisions about whether or not to be screened.
- Screening has become a substitute for trying to prevent cancer through lifestyle measures such as healthy eating and exercise, as it can be viewed as active in doing something positive for your health, even though the risk of cancer does not change at all.
- The same diet and lifestyle – based on whole plant foods – that can protect against cancer can also protect against heart disease, the leading cause of death in women.
There’s just so much confusion when it comes to mammography combined with the corrupting commercial interests of a billion dollar industry. As with any major health decision, everyone should be aware of the risks and benefits, and form their own opinion about their own body. This is the final part of my 14-part series on mammograms, which includes:
You can find more information about breast cancer in my videos Oxidized cholesterol 27HC may explain three secrets of breast cancer, Eggs and breast cancer and Flashback Friday: Can Flaxseed Prevent Breast Cancer?
I have produced so many videos on diet and lifestyle approaches to preventing and treating breast cancer. Just search for them on the website and you will see them all.
I was able to cover colon cancer screening in just one video. If you missed it, see Should we all have a colonoscopy over the age of 50?
You can also find information on preventive medical check-ups here Flashback Friday: Is It Worth Getting an Annual Health Checkup and Physical Exam?, Are annual health checks worthwhile? and Is it worth getting an annual physical exam?.
In health,
Michael Greger, MD
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