Screening Is Not Prevention

What will it take for prevention guidelines, such as those for screening mammograms, to be based on logic and evidence? Probably too much, according to Handel Reynolds.

It's a head-shaking bit of writing, and my head almost hit the table when I made the mistake of reading this comment on his op-ed. It quotes Reynolds, who wrote, quite accurately, "...because breast cancer is less common in women under 50, the task force found that in order to avert one death, 1,904 women in their 40s would have to be screened."

The commenter, buttefly62, responded: "I question this. I know two women who had breast cancer before the age of 40."

Yes, butterfly, we all know women under 40 who have had breast cancer, but that doesn't mean routine mammograms would have discovered it, and even if they had, that the discovery would have prevented death. And it doesn't take into account all of the over-treatment that happens because of unneeded screening tests.

Susan Perry at MinnPost recently recapped the Susan G. Komen ad brouhaha, and breast cancer surgeon David Gorski, writing at Science-Based Medicine, provided even more valuable information. Both do a good job of explaining why the five-year survival rate cited in the Komen ad (click the image to enlarge to a readable size) is beyond misleading.

Screening is not prevention. Common sense is not science. Wishful thinking doesn't cure anyone.

Update: An excellent discussion on MPR's The Daily Circuit about unnecessary medical testing with doctors from the Dartmouth University and the Cleveland Clinic. Worth a listen.