Reassessment Confirms: Screening Mammography Has No Survival Benefit LONDON (Reuters Health) Oct 18 - Despite the widespread ensuing uproar, Danish researchers maintain their original conclusion, based on a meta-analysis of published clinical trials, that screening mammography does not reduce mortality. After Drs. Ole Olsen and Peter C. Gotzsche of the Nordic Cochrane Centre in Denmark first reported results of their meta-analysis (see Medscapewire, January 10, 2000), "there was a storm of debate and criticism in national media and medical journals alike," Dr. Richard Horton, the editor of The Lancet, writes in the October 20th issue. In a Cochrane review, Drs. Olsen and Gotzsche reassessed their original analysis, closely attending to adequacy of randomisation methods, comparability of intervention and control groups at baseline, absence of biased post-randomisation exclusions, and reliability of outcome data. They also obtained additional information from the authors of each trial. The full review is available at http://image.thelancet.com/lancet/extra/fullreport.pdf. "We found that the results confirmed and strengthened our original conclusion," the Danish investigators write in The Lancet. Of the original seven randomised trials, they classified two as being of medium quality, three of poor quality, and two as flawed. None was judged to be of high quality. Neither the medium- nor the poor-quality trials showed any effect of screening on deaths ascribed to any cancer, including breast cancer. However, while the two medium-quality trials showed no effect of screening on the number of deaths ascribed to breast cancer after 13 years (relative risk 0.97), the three poor-quality trails showed a marked effect (relative risk 0.68). The researchers attribute the differences between the trials "to the methodological quality of the trials and not to the quality of the mammograms or the screening programmes." Based on data additional to the seven trials, which the Cochrane editors have elected to defer publishing pending further review, the researchers confirmed their original finding that screening leads to more aggressive treatment, with the number of mastectomies and tumourectomies increased by about 30%. Dr. Horton agrees with the investigators, concluding, "At present, there is no reliable evidence from large randomised trials to support screening mammography programmes." Lancet 2001;358:1284-1285,1340-1342. Commentary from Lancet, 2001:358: 1340-42 New York Times, Dec 9, 2001 This is the first NYT article News Coverage on Mammography Issues Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.