Article type
Year
Abstract
Background: Ever since the early 1970s, the American Cancer Society (ACS) has promoted mammography screening with the message: Find a breast cancer early---the smaller, the better-and your life will be saved. 67% of American women over the age of 40 report having had a mammogram in the last two years. A survey of U.S. women in 2000 showed that they considered the high rate of false-positives to be "an acceptable consequence of screening". However, the survey also found, "Most women are unaware that screening can detect cancers that may never progress". This year an estimated 49,000 American women will be diagnosed with ductal carcinoma in situ (DCIS), largely as a result of mammography screening. The majority will be treated with lumpectomy followed by six weeks of radiation therapy, and a minority will have a breast removed.
Objective: A rare opportunity to educate consumers about DCIS presented itself with the extensive media coverage given mammography screening as a result of the work of the Nordic Cochrane Centre. A review of all randomized controlled trials by Ole Olsen and Peter Gotzsche was published in The Lancet (October 20, 2001). The review raised questions about mammography's mortality-reduction benefit and contradicted the prevailing belief that screening leads to less-drastic treatment. Overtreatment of DCIS was identified as a considerable risk of mammography screening because most cases do not become invasive. We are in the process of conducting a survey of the media coverage given this review. We will determine how well DCIS-associated risks are conveyed to the public by the media and by policy makers.
Methods: The largest circulation news sources, including four major TV networks and National Public Radio, have been monitored since October by typing "mammography" periodically into the search engines of their Web sites. Each news item is assessed for the mammography-associated risk information imparted, both by the article/newscast itself and by the policy makers quoted within.
Results: Policy makers are prominent in the media coverage, as many try to stifle the debate over mammography's life-saving benefit because women might be "dissuaded from getting regular mammograms" and "lives will be lost". These concerns were at the heart of a full-page ad in the New York Times, sponsored by the ACS and nine other organizations that promote screening. The media interest continues as of March 2002. Thus far, there were 121 relevant news items, including editorials, letters to the editor, and commentaries. Of those that mentioned mammography-associated risks, most left the impression that false-positives and unnecessary biopsies are the most serious. The few that mentioned DCIS gave the subject on average one or two sentences.
Conclusions: To most consumers, the idea of a small cancer that is better off left undetected is counterintuitive. Good explanations of DCIS and its treatments are rare in the media coverage of the review by Ole Olsen and Peter Gotzsche. Policy makers are not giving consumers the risk information they need to make an informed decision whether to continue mammography screening.
Objective: A rare opportunity to educate consumers about DCIS presented itself with the extensive media coverage given mammography screening as a result of the work of the Nordic Cochrane Centre. A review of all randomized controlled trials by Ole Olsen and Peter Gotzsche was published in The Lancet (October 20, 2001). The review raised questions about mammography's mortality-reduction benefit and contradicted the prevailing belief that screening leads to less-drastic treatment. Overtreatment of DCIS was identified as a considerable risk of mammography screening because most cases do not become invasive. We are in the process of conducting a survey of the media coverage given this review. We will determine how well DCIS-associated risks are conveyed to the public by the media and by policy makers.
Methods: The largest circulation news sources, including four major TV networks and National Public Radio, have been monitored since October by typing "mammography" periodically into the search engines of their Web sites. Each news item is assessed for the mammography-associated risk information imparted, both by the article/newscast itself and by the policy makers quoted within.
Results: Policy makers are prominent in the media coverage, as many try to stifle the debate over mammography's life-saving benefit because women might be "dissuaded from getting regular mammograms" and "lives will be lost". These concerns were at the heart of a full-page ad in the New York Times, sponsored by the ACS and nine other organizations that promote screening. The media interest continues as of March 2002. Thus far, there were 121 relevant news items, including editorials, letters to the editor, and commentaries. Of those that mentioned mammography-associated risks, most left the impression that false-positives and unnecessary biopsies are the most serious. The few that mentioned DCIS gave the subject on average one or two sentences.
Conclusions: To most consumers, the idea of a small cancer that is better off left undetected is counterintuitive. Good explanations of DCIS and its treatments are rare in the media coverage of the review by Ole Olsen and Peter Gotzsche. Policy makers are not giving consumers the risk information they need to make an informed decision whether to continue mammography screening.