Date of Award

1995

Document Type

Thesis

Degree Name

Master of Science

First Advisor

Betty LeMasters

Second Advisor

Carolyn Scott

Third Advisor

Donna Fogarty

Abstract

This thesis will focus on the results of eight randomized studies and how these results were utilized by the National Cancer Institute (NCI) to change their guidelines for breast cancer screening mammography in women 40-49 years of age.

The incidence of breast cancer has been steadily on the rise since the 1970s. This increase in the number of new cases has caused some individuals to view breast cancer as an epidemic.

To date, research has not answered the question of what causes breast cancer, although their are many theories. Therefore, since the disease can not be prevented, women must rely on early detection and treatment to improve their chances of surviving this form of cancer. Early detection is comprised of three components: breast self-examination, clinical breast examination, and screening mammography.

But now, due to the results of eight studies conducted globally, the benefit of screening mammography in women aged 40 to 49 years of age is being scrutinized. These studies did not show a statistically significant decrease in mortality among women that were screened when compared to women not screened in that age group.

However, the present analysis is an attempt to qualify the decision made by the NCI by showing deficiencies in the studies that may have biased the results. Specifically, it is hypothesized that the NCI based their decision to change the guidelines on inaccurate information, and that they may have been motivated by a desire to reduce healthcare spending.

Results did point to numerous flaws in the study designs, as well as sampling problems and outdated technology. These results led to an acceptance of the hypothesis and conclusion that the NCI's decision may be based on a desire to control healthcare spending during a time when this appears to be on everyone's agenda.

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