Quantifying the benefits, harms of breast screening

Gilbert Welch, the co-author of a controversial article published in the New England Journal of Medicine in 2012 that questions the effectiveness of mammography when compared to the risks of overdiagnosis, has co-authored a new article attempting to quantify the benefits and harms associated with screening mammography.

The article was published Dec. 30 in JAMA Internal Medicine. On Dec. 29 Welch published an opinion piece in the New York Times in which he suggests that that a new round of two randomized clinical trials be performed.

"Women who view mammography favorably might be willing to be screened under either the current approach or a high-threshold approach--meaning their radiologist would ignore small, likely harmless abnormalities found on a mammogram," Welch said. "Those who view it less favorably might choose that high-threshold approach [knowing that the harms of false alarms and overdiagnosis would be minimized] or forgo mammography completely." Putting the results of the two studies together, Welch said, would finally answer the question of what level of screening "minimizes false alarms and overdiagnosis while saving the most lives." Article