Mammography screening : truth, lies and controversy / Peter C. Gøtzsche ; forewords by Iona Health and Fran Visco.

Format:

Book

Author/Creator:

Gøtzsche, Peter C.

Contributor:

Health, Iona.

Visco, Fran.

Language:

English

Subjects (All):

Breast--Radiography.

Breast.

Cancer--Diagnosis.

Cancer.

Medical screening.

Physical Description:

xi, 388 pages : illustrations ; 25 cm

Place of Publication:

London : Radcliffe Pub, 2012.

Summary:

When Gøtzsche (clinical research design and analysis, Nordic Cochrane Centre, U. of Copenhagen, Denmark) coauthored a review of mammography screening for breast cancer which documented the poor quality of many of the clinical trials on which several countries' policies are based and the extent of subsequent over-diagnosis and over-treatment, he created a controversy. He presents issues in cancer screening and examples of the biases and worse in clinical research, and misleading statistics reported in the media. The book includes a foreword by the president of the National Breast Cancer Coalition, US, and the author's leaflet on the benefits and risks of such screening. Published by Radcliffe Publishing, UK, and distributed in the US by BookMasters. Annotation ©2012 Book News, Inc., Portland, OR (booknews.com)

Contents:

1 Introduction 1

What it really means to be 'controversial' 5

Our collaboration with the media 10

2 Important issues in cancer screening 13

What it means 'to have cancer' 13

Overdiagnosis and overtreatment 15

Erroneous diagnoses and carcinoma in situ 16

Basic issues in cancer epidemiology 19

Randomised trials, observational studies and a little statistics 20

Why screening leads to misleading survival statistics 22

Why 10-year survival is also misleading 23

3 Does screening work in Sweden? 29

4 Stonewalling the Cochrane report on screening 34

The Danish National Board of Health interferes with our report 40

5 Troubling results in the Lancet 46

The Canadian trials 50

Media storm 52

Email from researchers 55

Our collaboration with the trialists 56

Ten letters to the editor 58

Creative manipulations in Sweden 60

Peter Dean, a remarkable character 63

Bad manners also in Norway 66

Continued troubles in Denmark 68

6 Harms dismissed by the Cochrane Breast Cancer Group 73

The process with the Cochrane review 75

Of mites and men 77

Confusion over who is in charge 78

7 The Lancet publishes the harms of screening 85

Vitriolic mass email from Peter Dean 90

Beating about the bush in the United Kingdom 93

Condemnations in Sweden 95

Contempt of science in Denmark and Norway 99

8 Delayed media storm in the United States after our 2001 reviews 103

Miettinen and Henschke's cherry-picking in the Lancet 107

Additional reactions in the United States 108

9 The Danish National Board of Health circles the wagons 114

10 US and Swedish 2002 meta-analyses 120

US Preventive Services Task Force's meta-analysis 120

Nyström's updated Swedish meta-analysis 121

11 Scientific debates in the United States 126

Peter Dean is wrong again 126

Multiple errors in the International Journal of Epidemiology 130

12 Publication of entire Cochrane review obstructed for 5 years 136

Cochrane editors stonewall our Cochrane review 138

Lessons for the future 143

Welcome results in France 145

13 Editorial misconduct in the European Journal of Cancer 147

Editorial misconduct 151

Threats, intimidation and falsehoods 155

Debates in the Scientist and the Cancer Letter 158

14 Tabár's 'beyond reason' studies 163

Criticism of our work in the Journal of Surgical Oncology 168

15 Other observational studies of breast cancer mortality 173

The United States and the United Kingdom 174

Denmark, Lynge's 2005 study 175

Denmark, our 2010 study 177

16 Overdiagnosis and overtreatment 185

Cancers that regress spontaneously 186

The 1986 UK Forrest report 188

Overdiagnosis in the randomised trials 189

Systematic-review of overdiagnosis in observational studies 194

Observational studies from Denmark and New South Wales 200

The doubt industry 202

Duffy's studies on overdiagnosis 205

Lynge's studies on overdiagnosis 207

Carcinoma in situ and the increase in mastectomies 210

17 Ad hominem attacks: a measure of desperation? 220

UK statistician publishes in Danish 222

Inappropriate name-dropping 223

Further ad hominem arguments 226

Lynge's unholy mixture of politics and science 227

Ad hominem attacks ad infinitum 230

18 US recommendations for women aged 40-49 years 238

19 What have women been told? 245

Website information on screening 245

Invitations to screening 247

A scandalous revision of the Danish screening leaflet 252

Our screening leaflet 254

Breast screening: the facts, or maybe not 255

American Cancer Society 262

Information from other cancer societies 267

Getting funding or not getting funding 271

What do women believe? 272

20 Extraordinary exaggerations 279

What is the ratio between benefits and harms? 280

Duffy's 'funny' numbers 282

Exaggerating 25-fold 287

The exaggerations finally backfire 292

The ultimate exaggeration 294

21 Tabár threatens the BMJ with litigation 298

22 Falsehoods and perceived censorship in Sweden 306

23 Celebrating 20 years of breast screening in the United Kingdom 311

24 Can screening work? 320

Plausible effect based on tumour sizes in the trials 320

Lead time 323

Plausible effect based on tumour stages in the trials 324

No decrease in advanced cancers 326

25 Where is screening at today? 331

Problems with reading mammograms 332

False promises 333

Important information is being ignored 336

Beliefs warp evidence at conferences 338

Does breast screening make women live longer? 340

26 Where next? 347

Is screening a religion? 351

A press release from Radiology that wasn't 352

Has all my struggle achieved anything? 353

Why has so much evidence about screening been distorted? 357

Time to stop breast cancer screening 358.

Notes:

Includes bibliographical references and index.

ISBN:

9781846195853

1846195853

OCLC:

774495441