That’s What You Get For Trusting a WSJ Editorial


By Joe Campbell
November 20th, 2009

[digg-reddit-me]Yesterday, the Wall Street Journal had an editorial that got passed around as if it were a news story, insisting that the decision of a board of doctors and scientists to recommend that biannual breast cancer screening only for those between the ages of 50 and 75 “is a sign of cost control to come.” The editorial cited this fact:

But the panel—which includes no oncologists and radiologists, who best know the medical literature—did decide to re-analyze the data with health-care spending as a core concern.

Yet this isn’t what news articles are reporting:

Panel members said politics and questions of cost were never part of their discussions of the risks and benefits of mammograms — in fact they are prohibited from considering costs when they make guidelines.

Or this:

In reaching its recommendations, the task force of doctors and scientists determined that early and frequent mammograms often lead to false-positive readings and unnecessary biopsies, without substantially improving the odds of survival for women under 50.

And it is not the rationale given by the report itself:

The harms resulting from screening for breast cancer include psychological harms, unnecessary imaging tests and biopsies in women without cancer, and inconvenience due to false-positive screening results. Furthermore, one must also consider the harms associated with treatment of cancer that would not become clinically apparent during a woman’s lifetime (overdiagnosis), as well as the harms of unnecessary earlier treatment of breast cancer that would have become clinically apparent but would not have shortened a woman’s life. Radiation exposure (from radiologic tests), although a minor concern, is also a consideration.

Adequate evidence suggests that the overall harms associated with mammography are moderate for every age group considered, although the main components of the harms shift over time. Although false-positive test results, overdiagnosis, and unnecessary earlier treatment are problems for all age groups, false-positive results are more common for women aged 40 to 49 years, whereas overdiagnosis is a greater concern for women in the older age groups.

There is adequate evidence that teaching BSE is associated with harms that are at least small. There is inadequate evidence concerning harms of CBE.

That hasn’t stopped this from becoming a right wing talking point nor from causing concerns among independents uncertain about whom to believe – the statements of the board itself, claiming they focused on science, or the speculating opinions of right wingers, playing into people’s worst fears.

I have some advice for those people on the fence: Read the damn report if you don’t trust the media. Don’t put your blind faith in the often discredited Wall Street Journal editorial page.