When Ronald Reagan had colon cancer surgery in 1985, many Americans became worried about their own health, and rushed off for a medical check. Two years later, when Nancy Reagan’s breast cancer hit the headlines, the numbers of women having mammography screening jumped.
Closer to home, when Kylie Minogue’s breast cancer hogged the front pages in 2005, many women also rushed off to have mammograms.
If history is any guide, it’s a fairly sure bet that the widespread publicity about Jane McGrath’s death from breast cancer will have a similar impact.
Many might assume that encouraging more women to be screened will be a good thing. We’ve had the message “early detection is better” drummed into us for so long that it’s not surprising if it’s stuck.
But the publicity about McGrath’s death has the potential to waste a lot of resources and possibly do harm if it leads to crowds of young women queuing for ultrasounds and mammograms.
Screening is only worth doing if the potential positives outweigh the potential negatives. The national breast cancer-screening program is aimed at women aged 50 to 69 because it is this age group where screening is judged worthwhile.
Thanks to researchers from the University of Sydney and Cancer Council Victoria, we know that the Minogue breast cancer publicity surge was accompanied by a big jump in the numbers of younger women having mammograms. More recently, a study by University of Melbourne researchers, reported in the International Journal of Epidemiology, outlined why this is such a concern.
They found that as a result of the increased screening of younger women, many more women ended up having biopsies but there was not the equivalent increase in cancer detection. In other words, many more women went through the trauma, cost and anxiety of unnecessary procedures.
The researchers said their findings “raise serious questions about whether the thousands of additional imaging procedures and biopsies ordered in Australia in the wake of Minogue’s highly publicised diagnosis resulted in improved breast cancer detection among young women.”
They added that both the public and doctors are vulnerable to the celebrity effect: “In the furore that surrounds a celebrity illness, holding the line on recommended care may be difficult.”
It’s not only individual women who have unnecessary investigations who are affected. There is also a cost to the system, and to those whose care may be compromised because of the additional burden on the system from the worried well.
It’s an issue that’s worth considering, given the likely impact of the current batch of headlines.
When tragedy strikes, it is a natural human instinct to want to respond with action. Sometimes, it’s wiser to recommend against action.
Researchers at the University of Sydney have developed a decision aid to help women in their 40s evaluate the pros and cons of mammography for their age group.