The wide-ranging and informative review of screening mammography(Juhl
& Gotzsche, 17Jan)identifies corporate contributions as a determining
factor in program and policy development by some breast cancer advocacy
groups. Since non-profit nongovernmental organizations(NGOs)always are
strapped for funds, corporations have found a fertile field for their
"greenwashing" tactics. When non-profits take these monies they accept
the corporate ethic that places profits above the public health, safety
and welfare. In fact, some of their leaders have gone through the
revolving door into the corporate sanctum sanctorum where they reach for
The Golden Ring(1) while others act as surrogates for industry on federal
agency advisory boards(2).
The authors never mention the potential health risks from radiation,
particularly when breast screening begins at age 40, as strongly
recommended by the American Cancer Society and the National Cancer
Institute(NCI), and you seldom see dose referenced(0.2-0.8rad, including
retakes). The historical review, PREVENTING BREAST CANCER: THE STORY OF A
MAJOR, PROVEN, PREVENTABLE CAUSE OF THIS DISEASE, by John W. Gofman,
former associate director of Lawrence Livermore National Laboratory, lists
27 studies that quantify cancer induction linked to radiation(3).
Cumulative dose should be a cause for concern as numerous studies now
demonstrate there is no safe dose(threshold). Future screening studies
should deal forthrightly with issues relating to x-ray dose and
risk/benefit, indicating this information must be communicated to patients
as required by the Nuremberg Code and the Helsinki Accords.
References
1. Ehrle LH. Partnerships between universities and
industry (letter). JAMA 2002;287:1398-1399.
2. Egilman DS, Ehrle LH. Handling conflicts of interest
between industry and academia. JAMA2003;289:3240-3241.
3. Gofman JW. Preventing Breast Cancer: The Story of a
Major, Proven, Preventable Cause of This Disease.
San Francisco: Committee for Nuclear Responsibility
Books, 1996(2nd ed).
Competing interests:
None declared
Competing interests:
No competing interests
05 February 2004
Lynn Howard Ehrle
Senior Policy Analyst, National Association for Public Health Policy(US)
Rapid Response:
Breast cancer screening and radiation risk
The wide-ranging and informative review of screening mammography(Juhl
& Gotzsche, 17Jan)identifies corporate contributions as a determining
factor in program and policy development by some breast cancer advocacy
groups. Since non-profit nongovernmental organizations(NGOs)always are
strapped for funds, corporations have found a fertile field for their
"greenwashing" tactics. When non-profits take these monies they accept
the corporate ethic that places profits above the public health, safety
and welfare. In fact, some of their leaders have gone through the
revolving door into the corporate sanctum sanctorum where they reach for
The Golden Ring(1) while others act as surrogates for industry on federal
agency advisory boards(2).
The authors never mention the potential health risks from radiation,
particularly when breast screening begins at age 40, as strongly
recommended by the American Cancer Society and the National Cancer
Institute(NCI), and you seldom see dose referenced(0.2-0.8rad, including
retakes). The historical review, PREVENTING BREAST CANCER: THE STORY OF A
MAJOR, PROVEN, PREVENTABLE CAUSE OF THIS DISEASE, by John W. Gofman,
former associate director of Lawrence Livermore National Laboratory, lists
27 studies that quantify cancer induction linked to radiation(3).
Cumulative dose should be a cause for concern as numerous studies now
demonstrate there is no safe dose(threshold). Future screening studies
should deal forthrightly with issues relating to x-ray dose and
risk/benefit, indicating this information must be communicated to patients
as required by the Nuremberg Code and the Helsinki Accords.
References
1. Ehrle LH. Partnerships between universities and
industry (letter). JAMA 2002;287:1398-1399.
2. Egilman DS, Ehrle LH. Handling conflicts of interest
between industry and academia. JAMA2003;289:3240-3241.
3. Gofman JW. Preventing Breast Cancer: The Story of a
Major, Proven, Preventable Cause of This Disease.
San Francisco: Committee for Nuclear Responsibility
Books, 1996(2nd ed).
Competing interests:
None declared
Competing interests: No competing interests