One of the bureaucratic divisions in Orwell’s classic 1984 is the Ministry of Truth which, of course, is anything but. Instead, it drowns the public in propaganda.
Today, we’re experiencing an anti-screening campaign of Orwellian proportions. And it’s being led by physicians, no less, who claim to be rising above emotion, and dealing only in scientific truth. Indeed, they have appointed themselves as the Ministry of Truth.
They are supported in their efforts by well-meaning journalists who, of course, have no interest in “dog bites man.” “Mammography saves lives” is stale and boring. But pull a switcheroo, and make that “mammography doesn’t save lives,” and you’ve got yourself a story.
Witness the Oct. 12, 2015 issue of TIME magazine where the cover states: “What If I Decide To Just Do Nothing?” The article itself brings up many valid and controversial points, but let me direct you to the sidebars, which I offer here verbatim: 1 in 800 – The chances of a woman in the U.S. getting diagnosed with invasive breast cancer. Or, 1 in 4,566 – The chances that a woman in the U.S. will die from breast cancer.
Don’t you feel better now? After all, you’ve been frightened out of your wits for many years with scare tactics that claimed, “1 in 8 women will be diagnosed with breast cancer.” Isn’t it refreshing to know the number is a mere “1 in 800?”
The cardinal rule in quoting risks happens to be: don’t ever toss a risk into the ring unless you attach it to “time.” Risks expressed as percentages without a time frame are, by definition, reckless and misleading. Critics of breast cancer screening love to point out how we’ve been terrifying the public for years with overstated risks. “One in 8” is the risk of developing breast cancer over a lifetime calculated through age 85 or 90, yet this has not always been made clear. So, to undo the damage, we apparently have a respectable news magazine doing the opposite – understating risk without proper explanation as to length of time.
How does “1 in 800” make sense? In fact, it is true if you’re talking about the risk of being diagnosed with breast cancer over the course of one year. Even then, “1 in 800” is under-kill, as this would only apply to a woman in her 40s. So, here’s the truth: There’s a “1 in 800” chance of being diagnosed with breast cancer during the next 12 months, if you’re a woman in her 40s. TIME’s sidebar is a shameful misrepresentation of risk. The same is true for their “1 in 4,566,” which is only accurate if talking about one year. In fact, the “lifetime risk” for dying of breast cancer is “1 in 35.”
Today’s counter-mantra seems clear: We are going to undo the sins of the past, even if it means misleading patients in the opposite direction. After all, “1 in 8” was also heavily promoted without specifying the duration of time to which this applied. So, we’re simply getting even.
The difference, however, is that lives will be lost by listening to the new Ministry of Truth.