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How The Swedish Mammography Study Should’ve Been Analyzed

We reviewed four stories on the Swedish mammography study that appeared in the journal Cancer last week. Three of the four stories gave a pretty clear indication that there were methodological concerns about the Swedish research (of the four reviewed, only HealthDay offered no such hint):

• 4th paragraph of AP story: “The new study has major limitations and cannot account for possibly big differences in the groups of women it compares.”

• 1st paragraph of LA Times blog story: “Critics charged that the study was poorly designed and potentially vastly misleading.”
• 2nd sentence of NY Times story: “Results were greeted with skepticism by some experts who say they may have overestimated the benefit.”

But none of the stories did a very complete job of explaining those potential limitations. Because of the confusion that must be occurring in the minds of women — especially those in their 40s — this is a time in which journalism must rise to the need and do a better job of evaluating evidence and helping readers make sense of what appear to be conflicting findings.

I was in Chapel Hill, North Carolina, when the study was published and had the chance to talk about it with former U.S. Preventive Services Task Force member, and a recognized thought leader on issues of prevention and especially of screening tests, Dr. Russell Harris, Professor and Director of the Health Care and Prevention Concentration of the University of North Carolina (UNC) School of Public Health. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

The Affordable Care Act: What’s Not Being Reported About Preventive Screening Benefits

One part of the health care law that took effect this week is widely reported as “establishing a menu of preventive procedures, such as colonoscopies, mammograms and cholesterol screening, that must be covered without co-payments.” For example, one of my local papers, the [St. Paul, Minnesota] Star Tribune, wrote: “Some people will no longer have to pay for copays, coinsurance or meet their deductibles for preventive care that’s backed up by the best scientific evidence.” (emphasis added)

That phrase should always include a huge asterisk, like the one hung on Roger Maris’ 61st home run. The best scientific evidence according to whom?

Time magazine reports, “Procedures, screenings and tests that are considered ‘preventive’ will be determined by the U.S. Preventive Services Task Force, the Centers for Disease Control (for vaccines) and the Health Resources and Services Administration.” As written, that is incorrect and inaccurate at worst and misleading at best. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Mammography: An Important Discussion To Keep Alive

This is a thoughtful “sounding board” piece in the New England Journal of Medicine this week: Lessons from the Mammography Wars.

It is so important to keep this discussion alive. The miscommunication that took place last November of what the U.S. Preventive Services Task Force tried to convey, and the complicity of some news organizations in adding to that confusion, provide lessons from which we simply must learn to do better.

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Dr. Oz’s First Colonoscopy Finds Pre-Cancerous Polyp: What Can This Teach Us?

Dr. LaPook and Dr. OzDr. Mehmet Oz just might be the last person on earth people would expect to get a colon polyp. He’s physically fit (he left me in the dust the last time we ran together), he eats a healthy diet, he doesn’t smoke, and he has no family history of colorectal cancer or colon polyps.

But several weeks ago, when Mehmet had his first screening colonoscopy at age 50, I removed a small adenomatous polyp that had the potential to turn into cancer over time. Statistically, most small polyps like his don’t become cancer. But almost all colon cancers begin as benign polyps that gradually become malignant over about 10 to 15 years.

Since there’s no way of knowing which polyps will turn bad, we take them all out. The good news is there’s plenty of opportunity to prevent cancer by removing these polyps while they are still benign. But only about 63 percent of Americans between ages 50 and 75 get screened for colorectal cancer. Read more »

(UPDATE) American Cancer Society: “Only” A Fundraising Ad, Right?

EDITOR’S NOTE: Following Gary Schwitzer’s HealthNewsReview.org August 11th blog post below entitled “American Cancer Society: ‘Only’ A Fundraising Ad, Right?”, the American Cancer Society pulled its “Screening Is Seeing” ad the next day.

See Schwitzer’s follow-up post “Screening Is Seeing” Ad By American Cancer Society-Cancer Action Network (ACS-CAN) Is Pulled” and a related article by Mary Carmichael of Newsweek: “The American Cancer Society’s Misleading New Ads.

Also see “Common Themes In The Alzheimer’s Test Stories And The Cancer Society Screening Ad” by Schwitzer.

(ORIGINAL POST)

American Cancer Society: “Only” A Fundraising Ad, Right?

A well-intentioned ad campaign run by the American Cancer Society is too vague, and therefore may leave impressions that are imbalanced, incomplete and unsubstantiated — the kind of common tactic seen in many drug company ads. That’s my opinion based on my analysis of the ad and based on my reading of the text.

An American Cancer Society news release states:

The American Cancer Society Cancer Action Network (ACS CAN) is launching a new print and online advertising campaign in congressional districts across the country this week, urging lawmakers to fully fund a lifesaving cancer prevention, early detection and diagnostic program that is celebrating 20 years of screening low income, uninsured, and medically underserved women for breast and cervical cancer. The ads also send the message that when it comes to increasing your odds of surviving cancer, access to evidence-based early detection tools is critical.

The ads reference the Centers for Disease Control and Prevention’s (CDC) National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which has a track record of reducing deaths from breast and cervical cancer. The program has provided more than 9 million screening exams to more than 3 million women and diagnosed more than 40,000 cases of breast cancer and more than 2,000 cases of cervical cancer since it launched in 1990. But with limited funding, the program is able to serve fewer than 1 in 5 eligible women.

The accomplishments of the CDC NBCCEDP are noteworthy. So this blog entry is no knock on that program. It’s a criticism of the ad. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

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