Could controversial Canadian mammography study spark new thinking in the U.S.?
A recent report from the Canadian National Breast Screening Study (CNBSS) concluded that mammography screening does not reduce deaths from breast cancer.
The findings refueled the heated debate that began in 2009 when the U.S. Preventive Services Task Force recommended biennial mammography screening for women ages 50 to 74 and individualized screening for younger women.
Two new commentaries published in Annals of Internal Medicine discuss the findings of the Canadian study and suggest new approaches to studying and thinking about breast cancer.
In the first commentary, the authors discuss the conclusiveness of trials that test the benefits and harms of mammography screening and suggest that it may be time for a new kind of study. They argue that the ultimate question for any cancer screening program is whether a reduction in cancer mortality really translates into saved lives. Current trials do not show evidence that mammography screening programs reduce overall mortality.
In the second commentary, the author suggests that the CNBSS report should help to reframe the issue of breast cancer to include discussion of prevention. The author suggests that we begin to look at screening in a more limited way and focus also on making lifestyle changes that are associated with a reduced risk for breast cancer.