Various health organizations offer contradicting mammography recommendations, ranging from annual mammograms from the age of 40 to the complete waiver of routine mammograms. Who can you trust
There are contradicting mammography recommendations, ranging from annual mammograms from the age of 40 to the complete abandonment of routine mammograms offered from various health organizations. With all the different conflicts of interest, it’s hard to know who to trust. A good place to Beginning is the US Preventive Services Task Force (USPSTF). His 2009 recommendations “ignited a firestorm” of controversy recommend postpone the start of routine mammograms from the age of 40 to 50 and have them every two years instead of annually. this evoked “A quick and decidedly passionate condemnation from the public, the media and also ardent supporters of screening within the medical profession itself.”
As I discuss in my video Flashback Friday: Should Women Over 40 Get a Mammogram?although most people never have heard the USPSTF is “considered the leading independent body in the private sector [nongovernmental] Experts in Breast Cancer Prevention and Primary Care ”and their“ evidence-based recommendations ”are considered the“ gold standard for prevention ”. It has a reputation for being more attached to science. For example the USPSTF recommended against teaching women to do breast self-exams. Why? Because it doesn’t seem to be working. It was put to the test when hundreds of thousands of women were randomized to do self-exams or not. Not only did the researchers find no benefit, they only found harm, including doubling the number of women who needed biopsies. Self-exams have not been shown to reduce the risk of developing breast cancer, dying from breast cancer, or catching tumors in earlier stages.
To be clear, the USPSTF wasn’t against breast self-exam – only against to teach Women to do them. This is because reminding women to do self-exams only appears to do harm and is of no benefit. If you notice anything unusual, be sure to inform your doctor. But telling women to learn the practice of looking seems to do more harm than good. Most doctors do continue To teach women to self-examine.
If self-exams have not proven helpful and are indeed harmful, why are doctors asking them over and over again? Because that’s exactly what we women have always told us. Medical indolence can trump women’s health without a billion-dollar industry pushing the practice to continue, and even without big business tipping the bill.
Let’s now Consider Mammograms. We spend billions of dollars in revenue every year by sticking to the status quo. Perhaps the “$ 8 billion annually spent on mammography screening could be better spent on something else,” even though “one person’s cost is another person’s income.” These billions of additional dollars from the status quo could “best explain the organized opposition to the implementation of the sensible USPSTF recommendations”. Chest radiologists, for example denounced the Panel of Experts, “suggesting that the panel’s members were guilty of callous disregard for the lives and well-being of women,” while the American College of Radiology receives Millions of dollars in donations from mammography equipment manufacturers.
In self-exams it was put to the test and the science was clear. It’s a no-brainer that that hurts predominate the benefits when there are obviously no benefits. The same appears This should be the case when mammography is started at the age of 40. It was put to the test to address “the population-wide effectiveness of mammography screening from the age of 40”. At first it looked like a 40+ screening might help, but eventually failed demonstrate a benefit in reducing the risk of dying from breast cancer. Instead, the researchers only found damage, including overdiagnosis and all of the chemotherapy, radiation, and surgery that resulted from detecting what looked like cancer but might never have caused problems if it hadn’t been picked up. But when the USPSTF tried to explain this again in its 2016 recommendations, the firestorm was over reignited with full-page advertisements in large newspapers. At 4:08 am in mine Video, I show one of these ads that asks, “Which of our mothers, wives, daughters, and sisters would it be okay to lose?” Statements like this “misrepresent” science and “respect our mothers, wives, daughters and sisters” rather than saving their lives. It is time to “put out the flames and remove the smoke so we can see clearly what the evidence is …”
Proof proof! was the reaction of Congress. Then they smuggled something into the Affordable Care Act “to interpret any reference to the ‘current’ USPSTF breast cancer screening recommendations is to those issued ‘prior to 2009’ – in other words, the 2002 recommendations “that recommended annual mammograms for ages 40 and over require Health insurers to ignore modern scientific assessments and use 14-year guidelines instead, “reads an article published in the prestigious Journal of the American Medical Association. “While many advocates of women’s health welcomed the Congressional mandate, it actually undermines the right of women to make informed decisions based on the best of science.”
This happened before 20 years ago when a consensus body from the National Cancer Institute and the Senate came to a similar conclusion chosen to “ignore” unanimously. The number one killer of death in women is heart disease. Why not focus our billions for more effective interventions? With funds for health care limited, perhaps we could do more for women’s health.
It could have been worse, however. The original bill “would have refused to fund a future USPSTF recommendation on mammography”. Period. “Some members of Congress have gone further, suggesting that the composition of the task force be changed to include ‘stakeholders from the medical device manufacturing community'” so that they can play a more direct role in influencing policy.
Wasn’t this self-examination wild? Counterintuitive results like these should serve as a warning as to why, ideally, we should be scrutinizing everything.
That’s one of the reasons I chose this topic. There is just so much confusion combined with the corrupting commercial interests of a billion dollar industry. As with any major health decision, everyone should be fully informed about the risks and benefits and form their own opinion about their own body. This is the third installment in a 14-part series. If you missed the first two, see Nine out of ten women are misinformed about mammograms and Mammogram Recommendations: Why The Conflicting Guidelines?.
For the rest of the series see:
THE CENTRAL THESES
- Recommendations for mammograms range from annual screenings from the age of 40 to complete avoidance, and conflicts of interest cloud the water.
- The US Preventive Services Task Force (USPSTF), recognized as the leading independent body of experts in breast cancer prevention and primary care, recommends routine mammograms from the age of 50.
- When the researchers found that doing self-exams did not reduce the risk of developing breast cancer, dying from breast cancer, or developing tumors in earlier stages, the USPSTF recommended not teaching women to do breast self-exams, but the most doctors are still teaching women to do them, probably due to medical indolence.
- The USPSTF’s “evidence-based recommendations” are considered the “gold standard for prevention,” but their guidelines have been widely criticized by the medical status quo. Indeed, the backlash against the USPSTF has been widespread and devastating, including from some members of Congress.
- Billions are spent on mammography screening each year, and the American College of Radiology receives millions in donations from mammography equipment manufacturers.
- When mammograms were put to the test from the age of 40, the researchers found that not only did they not show any benefit in reducing the risk of dying from breast cancer, but were actually harmful, such as from overdiagnosis and chemotherapy, Radiation, and surgery that resulted from the discovery of what looked like cancer but might never have caused problems if it hadn’t been picked up.
You can find more information about breast cancer in my videos Oxidized cholesterol 27HC can explain three secrets of breast cancer, Eggs and breast cancer and Flashback Friday: Can Flaxseed Prevent Breast Cancer?
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 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 doing an annual physical exam?.
Michael Greger, MD
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