Der Screening-Mythos

TORONTO – Das Mammographie-Screening gegen Brustkrebs wird seit langem als eine der wichtigsten Methoden zur Reduzierung der Sterblichkeit an dieser Krankheit angesehen. Deshalb sind die jüngsten Zweifel an der Effektivität der Methode – die sich durch die Veröffentlichung der 25-Jahres-Folgeuntersuchung zur Nationalen Kanadischen Studie über Brust-Screening noch verstärkt haben – so schockierend. Wie kann es sein, dass durch die Mammographie zur Früherkennung der Krankheit keine Todesfälle verhindert werden?

Um die Grenzen des Mammographie-Screenings zu erklären, müssen wir den Prozess zunächst verstehen. Ein Mammogramm (eine Röntgenaufnahme der Brust) wird bei scheinbar gesunden Menschen durchgeführt, um eine unerwartete Krankheit zu erkennen. Wenn Abnormalitäten gefunden werden, wird die Krankheit anhand eines diagnostischen Tests identifiziert. Bei positiven Ergebnissen wird mit der Behandlung begonnen.

Die erste Schwäche des Mammographie-Screenings ist offensichtlich: Wenn keine effektive Diagnose oder Behandlung möglich ist, ist es wirkungslos. Aber eine weitere Frage ist, ob die Mammographie ihren Zweck, die Sterblichkeitsraten durch Brustkrebs zu senken, überhaupt erfüllt.

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