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Those misleading media medicos

09/05/2013

Yet another misleading advertisement dressed up as a medical story on ABC Local Radio.

I missed the name of the group promoting increased funding for breast cancer screening.
Maybe it was an industry body, maybe an astroturfed ‘carers’ organisation, maybe a struggling group of dedicated activists.
Probably more complex than any of that.

But what they were claiming was that breast cancer death rates have come down substantially in recent decades because of screening.
They haven’t.

Oh, they’ve come down all right.
As with most other common cancers, breast cancer mortality in Australia has decreased by about a third over the last 20 years.
But screening has not been an important factor in that reduction.
In fact large scale studies in Europe and the US suggest that screening programs have no significant impact on breast cancer mortality.

The reduction in breast cancer mortality in Australia has partially been because of better treatments. (Alright, alright, including trastazumab and tamoxifen. Grr, I hate it when drug companies get something right.)

But mostly it hasn’t been due to what we’ve been doing at all.
Its due to what we’ve stopped doing.

Far fewer Australian women are poisoning themselves with cigarettes, so fewer are contracting breast or lung cancer.
But some still are.

And fewer Australian doctors are poisoning their menopausal patients with hormone replacement therapy (HRT).
But some still are.
And some of them want to see that increased.

In 2003 the Million Woman Study showed a strong correlation between ongoing HRT and breast cancer risk, confirming earlier research by the Women’s Health Initiative.
Those on oestrogen-only HRT were at 30% increased risk of developing breast cancer while for those on oestrogen-progestogen therapy the risk was doubled.
Those findings led to an immediate substantial reduction in HRT prescription across the developed world, followed by significant drops in breast cancer rates among immediately post menopausal women.
Several studies since then have confirmed the earlier findings.

Epidemiological data linking disease to cause doesn’t get much better than that.

But of late there has been an increasing number of industry shill endocrinologists casting bogus doubt on the Million Woman Study and the link between HRT and breast cancer.
And they’ve been getting an uncritical run on ABC Local Radio too.

In 2002 German psychologist Gerd Gigerenzer wrote Reckoning with Risk in which he illustrates several common ways of presenting statistics in a manner likely to mislead.
When he needed an example of a misleading public health campaign he chose the NSW breast screening program.
Over a decade later it seems it is only getting worse.

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From → radio, rant

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