Editor's note: The following editorial was published Tuesday in The (Rock Hill) Herald.
After years of trying to persuade women to get yearly mammograms, new studies suggest that routine screenings have become less critical in saving lives. But reversing earlier advice might be difficult.
A study published last month in the New England Journal of Medicine indicates that the benefits of mammography have dropped in recent years largely because of increased awareness and more effective treatments for breast cancer. Although previous studies found that mammography reduced deaths from breast cancer by about 25 percent, the new study showed a drop of 10 percent.
This, for the most part, is good news. It indicates, for one, that increasing awareness about breast cancer has paid off.
It also indicates that advances in treatment now save lives more effectively than intensive screening.
The new study followed the results after routine mammography was introduced to Norway. Based on that study, 2,500 women would have to be screened for 10 years for one of them to avoid death from breast cancer.
Meanwhile, at least 1,000 of those women would receive at least one false-positive result, and five to 15 would be diagnosed and treated for a condition that was never going to bother them.
In other words, mammograms aren't simply a "harmless" way to check for breast cancer. They often result in the anguish of false-positive results and unnecessary surgery.
Nonetheless, any mention of advising some women not to bother with yearly mammograms is guaranteed to raise a furor. Last year, a U.S. Preventive Services Task Force concluded that while screening women 50 or older was beneficial, screening women in their 40s had minimal benefits.
Critics immediately labeled the findings a first step toward rationing health care. Some viewed it as putting women's lives at risk to save money on health care costs.
But paying attention to the science and the numbers is important. The fact is that it really doesn't make sense to invest in massive screening programs that don't appreciably improve survival rates.
In the Norwegian study, for example, the death rate among women over 70 -- who did not undergo mammography but received the same care as younger women -- dropped by 8 percent. That suggests that the benefit of mammography may have been a little as 2 percent.
In other words, while mammograms might offer a sense of security, for many women they actually don't do much good.
Doctors and patients are likely to make the final decision on whether to continue screenings, which is as it should be. And we assume women who are known to be at greater risk will continue to be screened.
But as the research continues to pile up, methodology is likely to change -- even if it does so very slowly. Ultimately, though, it is preferable to concentrate money and care where it will do the most good.