Watch On-Demand Webcast from Tuesday, March 8, 2011

SUMMARY AND BACKGROUND

"We need to look more into the research, the science behind it. And the women need to be informed of the science behind it, and what that conveys, what does this mean." 8
- Mette Kalager

"The evidence is very clear that mammography does save lives. So, I think we have to have the science and the randomized controls accompanying what we're going to be thinking about in terms of policy." 10
- Felicia Knaul

"We need to incorporate primary prevention or risk reduction when we're looking at secondary prevention, which is essentially the screening with mammography." 9
- Julie Gralow

"[The WHO is] looking at the health of women, starting from when they are born, across their life cycle, to the next generation. And, by doing that, we are hoping that, in fact, we can advise better countries for illnesses that, in the past, were considered neglected or not a priority, like, for example, breast cancer and other type of cancers." 10
- Flavia Bustreo

Controversial new evidence suggests that mammography screening for women in high-income nations may have diminishing value in light of effective modern treatment options. But for women in lower-income nations, mammography screening is not enough of a priority, treatment is poor and women face greater risk. On March 8, 2011, International Women's Day, expert participants met at The Forum at Harvard School of Public Health to address the question, "Mammograms: Who in the world are they good for?"

Background

Breast Cancer in the Developing World: Meeting the Unforeseen Challenge to Women, Health and Equity (2009 symposium background materials): This international conference brought together delegates from around the world for the purpose of developing an action and research agenda to meet the challenge of breast cancer in developing countries.
Using Mammography to Screen Women for Breast Cancer May Be Less Effective in Reducing Death Rates than Previously Estimated: A New England Journal of Medicine study led by Harvard School of Public Health researchers found that a breast cancer-screening program in Norway resulted in a 10% decrease in breast cancer deaths in that age group.
Mammogram Benefit Seen for Women in Their 40s: A study published online in Cancer suggested that mammograms can decrease the breast cancer death rate by more than 25 percent for women in their 40s, but the study was met by some skepticism, reported The New York Times.
Expansion of cancer care and control in countries of low and middle income: a call to action: Cancer is not just a “disease of the rich” but is an often overlooked cause of death and disability in developing countries.
Breast cancer in Mexico: a pressing priority: Lead author and The Forum expert participant Felicia Knaul reports in this paper that since 2006 breast cancer accounts for more deaths than cervical cancer in Mexico.
Latin America's Silent Breast Cancer Epidemic: More education, information, and investment in early detection are needed in Latin America to fight breast cancer.
Breast cancer: a challenge for society and health systems: Salud Pública de México; in Spanish

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Mammograms

Moderator

Abigail Trafford - Author and Former Health Editor, The Washington Post

Expert Participants

Flavia Bustreo - Assistant Director-General, Family and Community Health, World Health Organization
Felicia Knaul - Director of the Harvard Global Equity Initiative, Secretariat of the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries
Mette Kalager - Researcher and lead author of The New England Journal of Medicine article offering a new assessment of mammography's effectiveness in reducing death rates. She also is a surgeon at Oslo University Hospital and is a visiting scientist at HSPH.
Julie Gralow - Professor and Director, Breast Medical Oncology, University of Washington / Seattle Cancer Care Alliance, and Associate Member, Fred Hutchinson Cancer Research Institute