The Mammography Dilemma: A Crisis for Evidence-Based Medicine?

Editorials3 September 2002The Mammography Dilemma: A Crisis for Evidence-Based Medicine?Steven N. Goodman, MD, MHS, PhDSteven N. Goodman, MD, MHS, PhDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-5_Part_1-200209030-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The newest contretemps over mammography is yet the latest eruption from a debate that has been simmering for decades, boiling over at regular intervals onto the front pages of newspapers, the floors of Congress, and the laps of expert panels (1). But a closer look at this controversy, which is officially joined here by publication of the rationale for the recommendations of the U.S. Preventive Services Task Force (USPSTF) (2), shows that its focus has shifted in a way that poses a dilemma not only for women and their doctors, but for evidence-based medicine itself.The debate in the 1990s ...References1. Lerner BH. The Breast Cancer Wars. New York: Oxford Univ Pr; 2001. Google Scholar2. Humphrey LL, Helfand M, Chan BK, Woolf SH. Breast cancer screening: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2002;137:347-60. LinkGoogle Scholar3. Olsen O, Gøtzsche PC. Cochrane review on screening for breast cancer with mammography [Letter]. Lancet. 2001;358:1340-2. [PMID: 11684218] CrossrefMedlineGoogle Scholar4. Olsen O, Gotzsche PC. Screening for breast cancer with mammography. Cochrane Database Syst Rev. 2001; CD001877. [PMID: 11687128] Google Scholar5. Olsen O, Gøtzsche P. Systematic review of screening for breast cancer with mammography. Accessed at image.thelancet.com/lancet/extra/fullreport.pdf on 23 July 2002. Google Scholar6. Miller AB. Screening for breast cancer with mammography [Letter]. Lancet. 2001; 358:2164; discussion 2167-8. [PMID: 11784651] Google Scholar7. Black WC, Haggstrom DA, Welch HG. All-cause mortality in randomized trials of cancer screening. J Natl Cancer Inst. 2002;94:167-73. [PMID: 11830606] CrossrefMedlineGoogle Scholar8. Nyström L, Andersson I, Bjurstam N, Frisell J, Nordenskjöld B, Rutqvist LE. Long-term effects of mammography screening: updated overview of the Swedish randomised trials. Lancet. 2002;359:909-19. [PMID: 11918907] CrossrefMedlineGoogle Scholar9. Berry D. Benefits and risks of screening mammography for women in their forties: a statistical appraisal. J Natl Cancer Inst. 1998;90:1431-9. [PMID: 9776408] CrossrefMedlineGoogle Scholar10. . Evidence-based medicine. A new approach to teaching the practice of medicine. Evidence-Based Medicine Working Group. JAMA. 1992;268:2420-5. [PMID: 1404801] CrossrefMedlineGoogle Scholar11. Harris RP, Helfand M, Woolf SH, Lohr KN, Mulrow CD, Teutsch SM, et al . Current methods of the US Preventive Services Task Force: a review of the process. Am J Prev Med. 2001;20 3 Suppl 21-35. [PMID: 11306229] CrossrefMedlineGoogle Scholar12. Haynes RB, Devereaux PJ, Guyatt GH. Physicians' and patients' choices in evidence based practice [Editorial]. BMJ. 2002;324:1350. [PMID: 12052789] CrossrefMedlineGoogle Scholar13. Feinstein AR, Horwitz RI. Problems in the “evidence” of “evidence-based medicine.”. Am J Med. 1997;103:529-35. [PMID: 9428837] CrossrefMedlineGoogle Scholar14. Ayer A. Philosophy in the Twentieth Century. New York: Random House; 1982. Google Scholar15. Lau J, Antman EM, Jimenez-Silva J, Kupelnick B, Mosteller F, Chalmers TC. Cumulative meta-analysis of therapeutic trials for myocardial infarction. N Engl J Med. 1992;327:248-54. [PMID: 1614465] CrossrefMedlineGoogle Scholar16. Greenland S, O'Rourke K. On the bias produced by quality scores in meta-analysis, and a hierarchical view of proposed solutions. Biostatistics. 2001;2:463-71. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Steven N. Goodman, MD, MHS, PhDCurrent Author Address: Steven N. Goodman, MD, MHS, PhD, Division of Biostatistics, Johns Hopkins Sidney Kimmel Cancer Center, Suite 1103, 550 North Broadway, Baltimore, MD 21205. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening for Breast Cancer: Recommendations and RationaleU.S. Preventive Services Task Force*Breast Cancer Screening: A Summary of the Evidence for the U.S. Preventive Services Task Force Linda L. Humphrey , Mark Helfand , Benjamin K.S. Chan , and Steven H. Woolf The Mammography Dilemma Alfred O. Berg , Janet Allan , and Steven Woolf The Mammography Dilemma Donald E. 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Stanley, MDPeut-on prévenir chimiquement le cancer du sein en 2003 ?Breast cancer screening: controversies and future directionsScreening for lung cancer: in pursuit of pre-metastatic diseaseConcepts and Controversies in Cancer ScreeningScreening Mammography for Younger Women: Back to BasicsHarold Sox, MD, EditorChemoprevention of breast cancer: a promising idea with an uncertain futureResearch Results That Clashed – What's the Right Answer? 3 September 2002Volume 137, Issue 5_Part_1Page: 363-365KeywordsBreast cancerDuctal carcinoma in situEvidence based medicineLumpectomyMammographyMastectomyMortalitySurgerySystematic reviews ePublished: 3 September 2002 Issue Published: 3 September 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...