“We don’t want people to panic,” Dr. Otis Brawley, chief medical officer of the cancer society, tells Gina Kolata of The New York Times in a front-page story. “But I’m admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated.”

It’s a bombshell, if true, and that’s presumably why it made the front page. Breast and prostate cancer screening have been over-rated, maybe by a lot.

Kolata, as I’ve noted here before, has made something of a career writing controversial stories on problems with cancer research and treatment. I’m not in a position to assess the accuracy of those stories, but they often generate strong dissent from critics who say the stories did not reflect all prevailing views.

Once again, Kolata has provoked controversy.

Peggy Peck of MedPage Today called it “a firestorm of controversy” in an article on the ABC News website. “The epicenter of the controversy,” she continued, “is [a] statement by Dr. Otis Brawley, chief medical officer of the ACS [American Cancer Society]. Brawley made the statement in an interview with the New York Times about a Journal of the American Medical Association analysis of breast and prostate cancer screening, which raised questions about claims that screening saves lives.”

J. Leonard Lichtenfeld, Deputy Chief Medical Officer for the national office of the American Cancer Society, likewise calls the reaction “a firestorm” on his Dr. Len’s Cancer Blog. But his view is dramatically different.

Kolata writes, conspiratorially, that the cancer society “is quietly working on a message, to put on its Web site early next year, to emphasize that screening for breast and prostate cancer and certain other cancers can come with a real risk of over-treating many small cancers while missing cancers that are deadly.”

“The American Cancer Society is not working on any stealth project to change commentary on our website to emphasize the shortcomings and risks of screening” says Lichtenfeld, who ought to know. “We don’t have to. You see, we already discuss these issues right there in plain view, including on this blog.“

Sharon Begley of Newsweek picks up Kolata’s theme, paraphrasing the Times. But no firestorm for Begley. Instead, she writes, “We are approaching a perfect storm on the fraught topic of screening.” [Emphasis mine.]

Jacob Goldstein takes a more balanced view in the Wall Street Journal‘s Health Blog.

“As we’ve pointed out before, the jury is still out on PSA testing for prostate cancer,” he writes, mentioning two studies that found mixed results. And regarding breast cancer, he says, “The evidence suggests that mammograms for women over 40 do save lives. Still, mammograms also lead to unnecessary treatment for many women while failing to save others, an analysis published this week in JAMA suggests.” It’s a short item, but a good one.

When I saw the hed on the U.S. News story, I thought I’d found independent confirmation of the cancer society’s stealth policy shift. But no. It is merely, once again, quoting the Times. “The American Cancer Society is shifting its stand on breast and prostate cancer screening, the New York Times reports…”

Maybe Kolata is right, despite what Lichtenfeld says. But maybe some of the others who quoted her could have called the cancer society and done a little reporting themselves.

According to the cancer society’s website, Becky Steinmark Erwin, its national director of media relations, is at  (404) 417-5860.

- Paul Raeburn

This entry was posted on Wednesday, October 21st, 2009 at 10:05 pm and is filed under Health & Medicine Stories. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.