Findings from the Institute of Medicine (IOM) have found that CT (computed tomography) scans are a major cause of the breast cancer they are supposed to detect, and women should avoid all ‘just-in-case’ and routine screening, a US government report has concluded.

Women should refuse to have any routine CT screening, say researchers from the University of California, at San Francisco (UCSF), who prepared their report on behalf of the US’s Institute of Medicine.

Instead, women, and especially those over the age of 50 — the major target group for routine imaging screening — should ask doctors the following questions:

• Is this scan absolutely necessary?
• Is it necessary to do it now?
• Are there other alternative tests?
• How can I be sure the test will be done in the safest way possible?
• Will having the scan results change the management of my disease (assuming the cancer is present)?
• Can I wait until after seeing a specialist before getting the scan?

Most doctors may not recommend thermography which is a safer option for breast cancer detection, so this options should also be requested even if it is at your expense.

Mammography Screening Increases Breast Cancer Mortality

In a Swedish study of 60,000 women, 70 percent of the mammographically detected tumors weren’t tumors at all. These “false positives” aren’t just financial and emotional strains, they may also lead to many unnecessary and invasive biopsies. In fact, 70 to 80 percent of all positive mammograms do not, upon biopsy, show any presence of cancer.

The use of CT has increased nearly 5-fold over the last 2 decades. Currently, 75 million CT scans are performed annually in the United States, around half in women, reflecting the large number of individuals who are exposed to this source of radiation. Thought leaders in radiology are often quoted as estimating that 30% or more of advanced imaging tests may be unnecessary, and while there are few scientific data to precisely estimate the amount of overuse, many radiologists believe the proportion may be even higher.
Perhaps one of the most damning reports was a large scale study by Johns Hopkins published in 2008 in the prestigious Journal of the American Medical Association’s Archives of Internal Medicine (Arch Intern Med. 2008;168[21:2302-2303). In the Background to the research it was pointed out that breast cancer diagnosis rates increased significantly in four Scandanavian counties after women there began receiving mammograms every two years. Now, there will be those who will simply argue that this just shows the power of mammograms to find (diagnose) breast cancer. They may well be talking rubbish.

In the study looking at two large scale groups of women in Norway, one having a mammogram every two years for 6 years, the other just at the end, the researchers themselves went on to conclude that they cannot link the increased incidence of breast cancer diagnosis simply to more real cases being detected because the rates among regularly screened women were significantly higher than rates among women of the same age who only received a mammogram at the end of the same six year period.

There are therefore three possible logical conclusions:

• The women in the control group who had a mammogram only at the end of year six somehow had their breast cancers heal themselves — the cancer went away without treatment.
• Not all the women diagnosed with irregularities actually had a problem that became breast cancer
• The more breast cancer screening you have, the more your incidence of breast cancer diagnosis increases.

The research was by no means a small study and compared 119,472 women screened every two years, with an identical group of 109,784 who had none.

The researchers themselves went on to conclude that the findings “provide new insight on what is arguably the major harm associated with mammographic screening, namely, the detection and treatment of cancers that would otherwise regress.”

That in itself is a truly important conclusion – the idea that if you leave a cancer alone (even if it has already had 20 divisions), the body can still heal itself.

Intense marketing focusing on profit leads to the rapid purchase of machines prior to completely understanding how this technology should be used to improve health outcomes has created excess capacity, complicated by few evidence-based guidelines for its use.

Strong financial incentives, reflected by the growing ownership of CT scanners by nonradiologists for use in their private medical offices, strong patient demand (in part resulting from direct-to-consumer advertisements that do not mention untoward effects), and medical malpractice concerns leading to defensive test ordering have all further contributed to high excess use.

Thus, while CT is clearly indicated and valuable in many cases–for example, for patients with acute appendicitis and pulmonary embolism–CT is frequently used in the absence of evidence. The threshold for using CT for imaging has dropped dramatically, and thus it is not surprising that the IOM suggested curtailing unnecessary radiation exposure from medical imaging to reduce cancer risks.

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