NCPA - Daily Policy Digest - Breast Cancer Prevention May Reduce Mortality

NATIONAL CENTER FOR POLICY ANALYSIS
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Breast Cancer Prevention May Reduce Mortality

For U.S. women who do not smoke, breast cancer has been the foremost cause of cancer deaths for the past century. Unfortunately, early detection and aggressive treatment has failed to reduce breast cancer death rates. By contrast, early detection through annual pelvic examinations and Pap smears, coupled with other measures, has reduced the age-adjusted death rate from uterine cancer by 80 percent in the last 70 years (see figure).

Mammography is being promoted in the belief that it leads to earlier diagnosis and treatment and thereby extension of life. But it sometimes leads to a shortening of life due to adverse effects of surgery, radiation and chemotherapy.

The use of mammography has been promoted far beyond its demonstrated intrinsic merits, according to physician R.T. Ravenholt:

In the United States in 1994, 61 percent of women over age 40 (about 32 million) reported having had mammograms during the past two years.

Mammograms increased diagnosed breast cancers but also generated more than five million false positive cancer diagnoses -- causing trauma to many millions of women.

The 100 million mammograms performed in the United States in the last decade failed to reduce mortality from breast cancer, which was 25.1 deaths per 100,000 women in 1995 -- the same level as in 1930.

Ravenholt says that as in lung cancer, where decades of aggressive treatment have failed to increase the five-year survival rate above five percent, the public health strategy against breast cancer may shift from early detection and aggressive therapy toward an emphasis on prevention -- particularly of recurrent and progressive breast cancer. Among women at risk for recurrence, raloxifene and tamoxifen can cut mortality to less than half. And preventive surgical enucleation of glandular breast tissue can cut mortality by as much as 90 percent.

Source: R.T. Ravenholt, "Breast Cancer -- Death Stats and Drug Prevention," February 12, 2002, American Council on Science and Health.

For text
http://www.healthfactsandfears.com/featured_articles/
feb2002/stats021202.html

For more on Prevention Preventive Medicine
http://www.ncpa.org/iss/hea

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