Detection Dilemma

摘要

The last time a panel of the National Cancer Institute (NCI) evaluated whether mammograms save lives, the group debated angrily until 2:30 in the morning, saw the resignation of a member who refused to "have my name associated with" its conclusions and received hysterical phone calls accusing them of trying to kill women. The cause of the 1997 furor? The judgment that "breast-cancer mortality is no lower in women who [received mammograms in their 40s] than in controls." That was five years ago. Last week another NCI panel waded into the mammogram wars and arrived at an even more radical position: not only does mammog-raphy not prolong the lives of younger women, but there is no persuasive evidence that mammograms for women over 50 make a difference. But this time the scientists were "essentially unanimous," says biostatistician and panel member Donald Berry of M.D. Anderson Cancer Center in Houston. There has not even been any hate mail (yet). And that is as remarkable as the conclusion itself. Says panel member Dr. Russell Harris of the University of North Carolina, "Some groups are now recognizing that mammography is not going to solve the problem of breast cancer."