From New York to California, the controversy raging over mammography has caused confusion for women. It is a perplexing issue. It began when the U.S. Department of Health and Human Services appointed a task force of medical experts to evaluate the effectiveness of mammography in the war on cancer.
Mammography -- defined as a low dose x-ray system to examine breasts -- is used for early detection of cancer. The advisory panel recommended that women should start breast screening at 50 and not at 40, the present standard. The panel warned that the benefits of screening women early -- saving one life for every 1904 women screened for 10 years -- were less than the potential for unnecessary tests and treatment and the worry that could cause.
In New York, Dr. Clare Bradley, chief medical officer for the American Cancer Society’s New York-New Jersey branch, told me: “The data we’ve looked at shows that screening women between 40 and 50 years old saves lives. It reduces the risk of dying by 15%.”
But, Dr. Samuel Epstein, an expert on prevention of cancer at the University of Illinois, disagrees vehemently. He says that screening women in their forties is “a disastrous policy.” Epstein claims the radiation women experience in getting mammograms can, in a 10-year period, pose a “major risk” of cancer.
Bradley says the New York-New Jersey branch of the ACS, tries to teach women to keep their weight down, avoid excessive drinking, and exercise -- all these, she declares, are weapons in the war on cancer. What’s mystifying is why the task force's recommendations have been repudiated by the Department of Health and Human Services -- the very agency that appointed it. Indeed, Kathleen Sibelius, secretary of that department, warned that the task force doesn’t set federal policy -- that doctors and patients should go on doing what they’ve been doing.
Epstein, who has written a book titled “The Politics of Cancer,” is convinced not enough attention has been paid to the risks of mammography. He claims that radiation from mammography is a thousand times greater than from a chest x-ray. But Dr. Bradley says the benefits from this procedure “far outweigh” the risks, that both younger and older women stand to benefit from testing at all ages above 40.
Throughout the country, and here in New York, younger women have protested the recommendations of the panel. And the issue has been politicized. Arguments on the floor of Congress have seen Republicans denouncing the task force’s recommendation as an indication of the flaws in the Obama administration’s health policies. The administration seems reluctant to defend the findings of its own panel.
Obviously, some of the risks here are political -- not physical.
It’s sad -- but science alone doesn’t seem to rule. As the Obama administration backs away from the recommendations of this panel, one can wonder what the ultimate policies will be. It’s puzzling. It’s frustrating.
As we said, it’s a mystery.