American women who get routine mammograms are more likely to be called back for additional tests than women in other countries, even though such caution does not result in more cases of breast cancer being found, a new study has found. 'Higher callback rates would be fine if we had evidence we're getting more bang for the buck,' said Dr. Joann Elmore, lead author of research published Wednesday in the Journal of the National Cancer Institute. 'But we're not.'" The study found that "American mammographers do not detect any more cases of breast cancer, nor do they detect cancer at earlier stages, than their counterparts in such countries as Australia, the Netherlands, Italy or Britain." They do, however, have a much higher false-positive rate: "According to one of Elmore's earlier studies, one in every two U.S. women will have at least one false positive after 10 years of annual screening. ... the authors say they have adjusted for most of the other factors that could lead to higher false-positive rates and hint strongly that America's litigious culture is implicated." ("Callbacks don't increase detection", Chicago Tribune/San Diego Network of Care, Sept. 17). See also Nov. 2, 2000; May 12, 2003; "Study suggests false-positive mammogram results linked to radiologists� experience", UW School of Medicine Online News, Sept. 27, 2002 (earlier Elmore research).
[cross-posted from Overlawyered where it ran Oct. 3, 2003]