Dr Daniel Kopans, professor of radiology at Harvard, earlier this week started a new blog entitled Fiction and Facts about Breast Cancer Screening to “provide women and their physicians with facts that they have probably not read before.” He described how the death rate from breast cancer has steadily declined since screening was introduced in the USA in the late 1980s, with an estimated 600,000 lives being saved. Kopans also drew attention to the tragic case of Dr Lisa Schwartz, professor at Dartmouth College, who died at age 55 in late 2018.
Schwartz and her husband Dr Steven Woloshin (seen above right, © Dartmouth Institute) were directors of the Center for Medicine and Media at Dartmouth where, according to her obituary, “they trained hundreds of journalists to become more skeptical about claimed scientific breakthroughs and miracle cures, and to better communicate the benefits and risks of medical tests and treatments.” Although Woloshin acknowledged his wife died from cancer, he did not mention that it was breast cancer, and one has to ask how it was diagnosed. Sadly, had Schwartz been participating in a breast screening programme beginning at age 40, she might well be alive today.
Kopans (seen left) followed up his first blog with a lengthier piece entitled “You can’t make this stuff up!” He took aim at the recent guidelines published by the American College of Physicians (ACP) that we featured last week. He stated: “The document is packed with misinformation and very dangerous ‘guidance’ that is, quite frankly, unbelievable and unethical.” Kopans then set about debunking the myths and misrepresentations in the ACP recommendations, citing 40 papers from the peer-reviewed literature:
(1) the panel ignored the scientific evidence that more lives are saved by annual screening starting at age 40; (2) no one who provides care for women with breast cancer was included on the panel; (3) there was no scale to judge the benefits (years of life gained, less rigorous treatment) versus the harms (false positives, overtreatment) of screening; (4) breast cancer is not a trivial problem for women aged 40 to 49; (5) there is little if any radiation risk to the breasts of women over 40; (6) even if it occurs, “overdiagnosis” is unaffected by delayed screening; (7) mammographically-detected breast cancers do not disappear on their own; and (8) the ACP failed to mention their guidelines would lead to tens of thousands of unnecessary deaths.
Kopans’ blog — which has the subtitle What You Don’t Know Can Hurt You — will provide a valuable counterweight to the anti-screening lobby.