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Researchers debating value of mammograms

After the large studies recently documenting the lack of value in screening for prostate cancer, medical researchers are now re-examining the value of mammograms in searching for breast cancer.  In an earlier web entry, we discussed the studies that followed almost a quarter-million men after screening for prostate cancer.  Researchers concluded that prostate cancer is normally relatively benign, that when it is aggressive, treatment rarely results in a cure, that treatment carries many severe complications, and as a result, 49 men suffer treatment complications for every one man whose life is saved by screening. 

Breast cancer presents similar issues, however, because breast cancer is NOT relatively benign [doctors frequently suggest to older men, on diagnosis, that "something else will kill you"], the value of screening for breast cancer is greater:  researchers at the Nordic Cochrane Center have estimated that between the ages of 50 and 70, ten women receive unnecessary treatment for every life saved.  Julietta Patnick, director of cancer screening for the British Health Service disputes that assessment and believes that the ratio is closer to 1:1. 

Dr. Ned Calonge, chairman of United States Preventive Services Task Force, thinks that mammogram screening has been "oversold" to women in the U.S., where patients are screened ten years earlier and more aggressively than in England.  English studies have suggested that even though screening is more effective in older women, 800 women above age 50 must be screened for 14 years to save a single life.  One analyst, Dr. Lisa Schwartz of Dartmouth Medical School, concluded "You're not crazy if you don't get screened, and your're not crazy if you do get screened."

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