Today’s Managing Health Care Costs Number is Nil
JAMA Internal Medicine electronically published a review of the impact of breast cancer screening on populations. The researchers reviewed county by county data in the SEER (Surveillance Epidemiology and End Results) database for breast cancer screening in 2000, and then looked at those diagnosed with breast cancer during that year. Then, they reviewed county-by-county breast cancer mortality rates for 10 years until the end of 2010.
They found that higher county-wide screening rates led to more diagnoses of cancer (every 10% increase in screening was associated with a 16% increase in diagnosis of breast cancer). However, almost the entire increase was for breast cancers that were small. Counties with more diagnosis of small breast cancers did not have a concomitant decrease in diagnosis of larger breast cancers.
At the end of ten years, there was no lower rate of breast cancer mortality in counties with high screening rates (and high detection rates) compared to those with low screening and detection rates.
The researchers:
The clearest result of mammography screening is the diagnosis of additional small cancers. Furthermore, there is no concomitant decline in the detection of larger cancers, which might explain the absence of any significant difference in the overall rate of death from the disease. Together, these findings suggest widespread overdiagnosis.
Screening makes great intuitive sense, and we deeply want to find breast cancer "before it's too late." On a population basis, this study casts serious doubt on the effectiveness of mammography as a screening tool.
H/T to Julia Belluz of vox.com, who reported this before I even saw the email release. She also reprinted a helpful graphic demonstrating the impact of breast cancer screening.
