publication date: Feb. 10, 2012
The Susan G. Komen for the Cure Foundation and Planned Parenthood may have
had their differences over reproductive politics, but they march in lockstep when they
overstate the promise of breast cancer screening to young women, a group of experts
said to The Cancer Letter.
Much of the controversy over screening mammography is focused on women
between the ages of 40 and 49. No responsible health authorities suggest starting to
screen earlier, before the age of 40.
Yet, nearly all the women Planned Parenthood serves are in their twenties and
thirties—and the health claims these women see on the organization’s website go far
beyond the evidence-based recommendations of the U.S. Preventive Services Task Force.
The group’s clinical guidelines, which presumably determine what happens in the
Planned Parenthood clinics, appear to have been compiled cafeteria-style, combining
elements of guidelines used by other organizations and professional societies.
Planned Parenthood’s website declares that screening saves lives, a point not
proven even in an older population, and prominently features a scary anecdote: a
27-year-old woman identified as Colleen L., of Loudonville, N.Y., discovers a lump in her
breast. “There is no doubt in my mind that Planned Parenthood saved my life,” Colleen
writes in a testimonial.
On the website, Planned Parenthood’s top doctor discusses clinical breast exams,
breast self-exams and screening mammography in a population that is, by definition,
The fact that the data don’t provide a solid justification for using clinical breast
exams and self-exams to screen in any age group is not mentioned.
In 2010, more than 88 percent of women who relied on Planned Parenthood were
35 and younger, according to a spokesperson. No numbers were provided for the
The Cancer Letter asked experts in evidence-based medicine to review the information
Evaluations by the four experts suggest that Komen’s instinct to bar Planned Parenthood
from receiving future funding may have been right, albeit for wrong reasons. It would have been
appropriate to withdraw the funds because Planned Parenthood apparently fails to discuss the
known risks of screening for breast cancer as it promotes screening to young women, whose
chances of being harmed could outweigh the chances of seeing a benefit.
These experts are:
• Donald Berry, a biostatistician at M.D. Anderson Cancer Center, who was involved in
preparing the USPSTF breast cancer screening guideline.
• Russell Harris, a former USPSTF member and professor of medicine in the Division of
General Medicine and Clinical Epidemiology at the University of North Carolina School of Medicine,
Chapel Hill, and director of the UNC School of Medicine Program on Prevention in Education and Practice.
• Lisa Schwartz and Steven Woloshin, professors of medicine at Dartmouth Medical School,
whose research is focused on communication of medical statistics and information about the
benefits and harms of screening and prescription drugs.