Medscape Covers Sprague Editorial on Potential Mammography Overscreening
Medscape reported on an editorial by Brian Sprague, Ph.D., M.S., University of Vermont Cancer Center member and Larner professor of surgery, radiology, and biochemistry, and a colleague at the University of Wisconsin–Madison that was published in Annals of Internal Medicine. The editorial accompanied a study on mammography screening that suggested the possibility of overscreening despite guidelines recommending biennial screening for average-risk women age 55 years or older.
The editorial agreed with the study authors that the data pointed to potential overuse, including annual vs biennial intervals and screening beyond the age when early detection would confer a mortality benefit. “Given the long-term persistence of annual mammography as the dominant interval, most patients and clinicians seem to consistently place greater weight on the potential benefits than harms of more intense screening regimens,” the editorial authors wrote. “Numerous evidence-based interventions are available where broader implementation could improve alignment between screening use, guidelines, a patient’s individual risk for breast cancer, and their personal preferences.”
The editorial commentators cautioned, however, that NHIS data are susceptible to misclassification due to self-report, selection bias, and other threats to validity, and they lack measures required for breast cancer risk assessment and monitoring of screening use by risk level. Nevertheless, they said, such public health surveillance data provide a critical benchmark against which all other studies should be compared.