Violence in cities; Mubarak deja vu?

CAIRO (Reuters) - Angry youths hurled rocks at security forces and burned a police truck as thousands gathered in central Cairo to protest at Egyptian President Mohamed Mursi's decision to grab sweeping new powers.

Police fired tear gas near Tahrir Square, heart of the 2011 uprising that toppled Hosni Mubarak at the height of the Arab Spring. Thousands demanded that Mursi should quit and accused him of launching a "coup".

There were also violent protests in Alexandria, Port Said and Suez.

Mursi on Thursday issued a decree that puts his decisions beyond any legal challenge until a new parliament is elected. Opponents immediately accused him of turning into a new Mubarak and hijacking the Egyptian revolution.

"This is the point of no return for Mursi. He has dug himself deeper in a hole and won't know how to get out of it," said Ahmed Saleh, an activist who said many would stay in Tahrir square until Mursi withdrew the decree.

"The people want to bring down the regime," shouted protesters in Tahrir, echoing a chant used in the uprising that forced Mubarak to step down.

The United States, the European Union and the United Nations expressed concern at Mursi's move.

Mursi's rivals condemned him as an autocratic pharaoh who wanted to impose his Islamist vision on Egypt.

The president's aides said the decree was intended to speed up a protracted transition to democracy that has been hindered by legal obstacles

"I am for all Egyptians," Mursi said on a stage outside the presidential palace, adding that he was working for social and economic stability and remained committed to the revolution.

JUDGES MEET

Egyptian judges will meet on Saturday to respond to Mursi's move, which put him above the judicial oversight. The judges could threaten to go on strike, which would bring the judiciary to a halt.

Some non-Islamist political parties called for a million-strong march on Tuesday to demand that Mursi rescinds his decree.

But Islamist parties, including the Building and Development Party, accused Mursi's opponents of undermining the democratic process that brought him to office.

"Those calling for the downfall of President Mohamed Mursi have rejected democracy because President Mursi has been democratically elected by popular will," the party said in a statement. Mursi's decree would "save the revolution from the remnants of Mubarak's regime", it said.

Buoyed by accolades from around the world for mediating a truce between Hamas and Israel in the Gaza Strip, Mursi on Thursday ordered that an Islamist-dominated assembly writing the new constitution could not be dissolved by legal challenges.

Mursi, an Islamist whose roots are in the Muslim Brotherhood, also gave himself wide powers that allowed him to sack the unpopular public prosecutor and opened the door for a retrial for Mubarak and his aides.

TURBULENCE AND TURMOIL

The president's decree has consolidated his power but looks set to polarize Egypt further, threatening more turmoil in a nation at the heart of the Arab Spring.

In Alexandria, north of Cairo, protesters ransacked an office of the Brotherhood's political party, burning books and chairs in the street. Supporters of Mursi and opponents clashed elsewhere in the city, leaving 12 injured.

A party building was attacked by stone-throwing protesters in Port Said, and demonstrators in Suez threw petrol bombs that burned banners outside the party building.

Although Washington has praised Egypt for its part in bringing Israelis and Palestinians to a ceasefire on Wednesday, it expressed reservations about Mursi's latest move.

"The decisions and declarations announced on November 22 raise concerns for many Egyptians and for the international community," State Department spokeswoman Victoria Nuland said in a statement.

The European Union urged Mursi to respect the democratic process, while the United Nations expressed fears about human rights.

"The decree is basically a coup on state institutions and the rule of law that is likely to undermine the revolution and the transition to democracy," said Mervat Ahmed, an independent activist in Tahrir protesting against the decree.

Leading liberal Mohamed ElBaradei, who joined other politicians on Thursday night to demand the decree was withdrawn, wrote on his Twitter account that Mursi had "usurped all state powers and appointed himself Egypt's new pharaoh".

Almost two years after Mubarak was toppled and about five months since Mursi took office, Egypt has no permanent constitution, which must be in place before new parliamentary elections are held.

An assembly drawing up the constitution has yet to complete its work. Many liberals, Christians and others have walked out accusing the Islamists who dominate it of ignoring their voices over the extent that Islam should be enshrined in the new state.

(Additional reporting by Tom Miles in Geneva and Sebastian Moffett in Brussels; Editing by Giles Elgood)

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Large explosion reported in Massachusetts city

WASHINGTON: An explosion thought to have been triggered by a gas leak levelled a bar in downtown Springfield, Massachusetts on Friday, moments after dancers were warned to flee, local media reported.

WWLP TV quoted police as saying several people were taken to local hospitals by ambulance after the Friday afternoon explosion, which blew out windows two blocks away and knocked people to the ground.

The building housing the Scores Gentlemen's Club was flattened by the blast, the Republican newspaper said on its website. WWLP said two buildings were destroyed in the explosion.

Dancers at Scores told the newspaper they were warned by a manager to clear out of the building, and were having a drink in a bar across the street when their workplace blew up.

A dancer who identified herself only as Deb said she was on stage dancing when a "house mom" told everyone to evacuate, according to the newspaper.

She said she saw smoke in the upstairs floor of the building as she was gathering her clothes.

At that point, she said, the manager told everyone: "I don't care if you're (expletive) naked or not, get out."

She said there had been a smell of gas all week, and that the gas company had been called in but had found nothing.

- AFP/xq

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Cash transfer: PM to play UPA-2's trump card on Monday

NEW DELHI: The Prime Minister is expected to formally kick off cash transfer of subsidies and entitlements, one of the most ambitious policy initiatives of UPA-2, on Monday. The scheme for cash transfers is visualized as a game-changer for UPA-2, like NREGA was for UPA-1, and is expected to give rich dividends at the elections.

Manmohan Singh is expected to set January 1, 2013 as the launch date for the rollout when he meets his ministerial colleagues on Monday. The plan to transfer cash directly into bank accounts of beneficiaries instead of handing over subsidised foodgrains, fertilizer or fuel is aimed to not only check leakages from the system, but also empower consumers with the choices and ensure big savings for the cash-strapped government.

Compared to NREGA, the size and scale of the cash-transfer programme is several times the rural job guarantee scheme, with the government planning to transfer over Rs 4 lakh crore annually to the public, with each BPL (below poverty line) family getting over Rs 3,000 a month.

Sources said the PM is also planning to address the nation on the scheme in the coming days, explaining the ambitious plan that would be bigger than similar programmes around the world. The government, which accords high importance to the scheme, proposes to appoint a national coordinator to oversee the programme. It will also ensure its rapid scalability.

Singh on Monday will address a meeting of ministers in-charge of subsidies, pension and scholarships and there he will disclose the government intent to formally launch the programme on January 1. The programme would begin by covering 51 districts where the Aadhar card has a high penetration. By April 1 next year, 18 states will be covered.

A senior official said the Planning Commission has identified seven flagship programmes, including pensions and 22 scholarship schemes given by nine central ministries, for cash transfers, excluding those related to subsidies on food, fertilizer and fuel.

Ministries are being asked to digitize their databases of beneficiaries and link them with Aadhar, so that Aadhar-enabled bank accounts and Aadhar-enabled payment systems can function through what's being called the Aadhar Payment Bridge - essentially, a mechanism for giving cash cards to beneficiaries who don't have bank accounts.

According to latest estimates provided by the Department of Financial Services, by March 31, 2012 all banks will migrate to the core banking platform which will facilitate direct cash transfers. The plan is to cover all villages with a population of more than 5,000 with branches, and those with population of more than 2,000 with business correspondents. Seven states have committed to make electronic payments.

Times View

The government clearly believes that cash transfers can be a game-changer. In theory, they would indeed appear to be justified in this view. However, whether the practice lives up to the theory is what will ultimately determine how much of a game-changer this move is and whether the change is for the better or for worse. That is why it is important that the government acts as soon as possible to even out the more obvious glitches to smooth implementation of cash transfers, like a large proportion of the population having neither identification documents nor bank accounts. This is particularly true of the poorest sections, who really ought to be the main beneficiaries of the government's welfare programmes.

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Black Friday: Bargains, Brawls and Gunfire

Two people were shot outside a Walmart in Florida today, one of a rash of fights, robberies and other incidents that have cropped up on one of the most ballyhooed shopping days of the year.

The shooting took place at a Walmart in Tallahassee about 12:30 p.m., said Dave Northway, public information officer for the Tallahassee Police Department.

Investigators believe a scuffle over a parking space outside the store escalated into gunplay leaving two people shot.

The two victims, whose names and genders have not been released, were taken to a hospital with what are believed to be non-life threatening injuries.

Police are looking for a dark green Toyota Camry in connection with this case.

At a Walmart parking lot on Thanksgiving night in Covington, Wash., two people were run down by a driver police suspected of being intoxicated.

The 71-year-old driver was arrested on a vehicular assault charge after the incident, spokeswoman Sgt. Cindi West of the Kings County Sheriff's Office said.

The female victim, whose identity has yet to be released, was pinned beneath the driver's Mercury SUV until being rescued by the fire department. She was flown to Harborview Medical Center, where she was listed in serious condition, West said.

The male victim was also taken to Harborview Medical Center, where, West said, he was listed in good condition.

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Tensions were high at the entrances as people lined up outside stores, waiting for the doors to open.

At a San Antonio, Texas, Sears, one man argued with customers and even punched one in order to get to the front of the line, prompting a man with a concealed carry permit to pull a gun, said Matthew Porter, public information officer of the San Antonio Police Department.

"It was a little chaotic. People were exiting the store," Porter said. "Fortunately for us, officers responded quickly and were able to ease the commotion."

The man who allegedly caused the altercation fled the scene and remains at large, Porter said. The shopper who pulled the gun will not face charges, he said, because of his concealed carry permit.

One man was treated at the scene for injuries sustained when people rushed out of the store, Porter said.

PHOTOS: Black Friday Shoppers Hit Stores

The crush of shoppers in the middle of the night were prey once again this year for thieves, who hid out in parking lots.

In Myrtle Beach, S.C., a woman said a man pulled a gun on her just as she exited her car to go inside a Best Buy store. The thief made off with $200, according to a police report.

In Maryland, 14-year-old boy told police he was robbed of his Thanksgiving night purchases by five men in the parking lot of a Bed Bath and Beyond store early this morning, the Baltimore Sun reported.

And in Massachusetts, Kmart employees tried to locate a shopper over the intercom after a 2-year-old was reported to be alone in a car, ABC News affiliate WCVB-TV reported.

Police arrived to break into the car and remove the child. The boy's caretaker, his mother's boyfriend, denied the incident took place, according to the station, and was not arrested.

ABC News' Candace Smith contributed to this report

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AP PHOTOS: Simple surgery heals blind Indonesians

PADANG SIDEMPUAN, Indonesia (AP) — They came from the remotest parts of Indonesia, taking crowded overnight ferries and riding for hours in cars or buses — all in the hope that a simple, and free, surgical procedure would restore their eyesight.

Many patients were elderly and needed help to reach two hospitals in Sumatra where mass eye camps were held earlier this month by Nepalese surgeon Dr. Sanduk Ruit. During eight days, more than 1,400 cataracts were removed.

The patients camped out, sleeping side-by-side on military cots, eating donated food while fire trucks supplied water for showers and toilets. Many who had given up hope of seeing again left smiling after their bandages were removed.

"I've been blind for three years, and it's really bad," said Arlita Tobing, 65, whose sight was restored after the surgery. "I worked on someone's farm, but I couldn't work anymore."

Indonesia has one of the highest rates of blindness in the world, making it a target country for Ruit who travels throughout the developing world holding free mass eye camps while training doctors to perform the simple, stitch-free procedure he pioneered. He often visits hard-to-reach remote areas where health care is scarce and patients are poor. He believes that by teaching doctors how to perform his method of cataract removal, the rate of blindness can be reduced worldwide.

Cataracts are the leading cause of blindness globally, affecting about 20 million people who mostly live in poor countries, according to the World Health Organization.

"We get only one life, and that life is very short. I am blessed by God to have this opportunity," said Ruit, who runs the Tilganga Eye Center in Katmandu, Nepal. "The most important of that is training, taking the idea to other people."

During the recent camps, Ruit trained six doctors from Indonesia, Thailand and Singapore.

Here, in images, are scenes from the mobile eye camps:

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Gaza ceasefire holds but mistrust runs deep

GAZA/JERUSALEM (Reuters) - A ceasefire between Israel and Hamas held firm on Thursday with scenes of joy among the ruins in Gaza over what Palestinians hailed as a victory, and both sides saying their fingers were still on the trigger.

In the sudden calm, Palestinians who had been under Israeli bombs for eight days poured into Gaza streets for a celebratory rally, walking past wrecked houses and government buildings.

But as a precaution, schools stayed closed in southern Israel, where nerves were jangled by warning sirens - a false alarm, the army said - after a constant rain of rockets during the most serious Israeli-Palestinian fighting in four years.

Israel had launched its strikes last week with a declared aim of ending rocket attacks on its territory from Gaza, ruled by the Islamist militant group Hamas, which denies Israel's right to exist. Hamas had responded with more rockets.

The truce brokered by Egypt's new Islamist leaders, working with the United States, headed off an Israeli invasion of Gaza.

It was the fruit of intensive diplomacy spurred by U.S. President Barack Obama, who sent his secretary of state to Cairo and backed her up with phone calls to Israeli Prime Minister Benjamin Netanyahu and Egyptian President Mohamed Mursi.

Mursi's role in cajoling his Islamist soulmates in Gaza into the U.S.-backed deal with Israel suggested that Washington can find ways to cooperate with the Muslim Brotherhood leader whom Egyptians elected after toppling former U.S. ally Hosni Mubarak, a bulwark of American policy in the Middle East for 30 years.

Mursi, preoccupied with Egypt's economic crisis, cannot afford to tamper with a 1979 peace treaty with Israel, despite its unpopularity with Egyptians, and needs U.S. financial aid.

MORE DEATHS

Despite the quiet on the battlefield, the death toll from the Gaza conflict crept up on both sides.

The body of Mohammed al-Dalu, 25, was recovered from the rubble of a house where nine of his relatives - four children and five women - were killed by an Israeli bomb this week.

That raised to 163 the number of Palestinians killed, more than half of them civilians, including 37 children, during the Israeli onslaught, according to Gaza medical officials.

Nearly 1,400 rockets struck Israel, killing four civilians and two soldiers, including an officer who died on Thursday of wounds sustained the day before, the Israeli army said.

Israel dropped 1,000 times as much explosive on the Gaza Strip as landed on its soil, Defense Minister Ehud Barak said.

Municipal workers in Gaza began cleaning streets and removing the rubble of bombed buildings. Stores opened and people flocked to markets to buy food.

Jubilant crowds celebrated, with most people waving green Hamas flags but some carrying the yellow emblems of the rival Fatah group, led by Western-backed President Mahmoud Abbas.

That marked a rare show of unity five years after Hamas, which won a Palestinian poll in 2006, forcibly wrested Gaza from Fatah, still dominant in the Israeli-occupied West Bank.

Israel began ferrying tanks northwards, away from the border, on transporters. It plans to discharge gradually tens of thousands of reservists called up for a possible Gaza invasion.

But trust between Israel and Hamas remains in short supply and both said they might well have to fight again.

"The battle with the enemy has not ended yet," Abu Ubaida, spokesman of Hamas's armed wing Izz el-Deen Al-Qassam Brigades, said at an event to mourn its acting military chief Ahmed al-Jaabari, whose killing by Israel on November 14 set off this round.

"HANDS ON TRIGGER"

The exiled leader of Hamas, Khaled Meshaal, said in Cairo his Islamist movement would respect the truce, but warned that if Israel violated it "our hands are on the trigger".

Netanyahu said he had agreed to "exhaust this opportunity for an extended truce", but told Israelis a tougher approach might be required in the future.

Facing a national election in two months, he swiftly came under fire from opposition politicians who had rallied to his side during the fighting but now contend he emerged from the conflict with no real gains for Israel.

"You don't settle with terrorism, you defeat it. And unfortunately, a decisive victory has not been achieved and we did not recharge our deterrence," Shaul Mofaz, leader of the main opposition Kadima party, wrote on his Facebook page.

In a speech, Ismail Haniyeh, Hamas's prime minister in Gaza, urged all Palestinian factions to respect the ceasefire and said his government and security services would monitor compliance.

According to a text of the agreement seen by Reuters, both sides should halt all hostilities, with Israel desisting from incursions and targeting of individuals, while all Palestinian factions should cease rocket fire and cross-border attacks.

The deal also provides for easing Israeli curbs on Gaza's residents, but the two sides disagreed on what this meant.

Israeli sources said Israel would not lift a blockade of the enclave it enforced after Hamas won a Palestinian election in 2006, but Meshaal said the deal covered the opening of all of the territory's border crossings with Israel and Egypt.

Israel let dozens of trucks carry supplies into the Palestinian enclave during the fighting. Residents there have long complained that Israeli restrictions blight their economy.

Barak said Hamas, which declared November 22 a national holiday to mark its "victory", had suffered heavy military blows.

"A large part of the mid-range rockets were destroyed. Hamas managed to hit Israel's built-up areas with around a metric tone of explosives, and Gaza targets got around 1,000 metric tonnes," he said.

He dismissed a ceasefire text published by Hamas, saying: "The right to self-defense trumps any piece of paper."

He appeared to confirm, however, a Hamas claim that the Israelis would no longer enforce a no-go zone on the Gaza side of the frontier that the army says has prevented Hamas raids.

(Additional reporting by Noah Browning in Gaza, Ori Lewis, Crispian Balmer and Dan Williams in Jerusalem; Writing by Jeffrey Heller and Alistair Lyon; Editing by Giles Elgood)

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Japanese police rescue bank hostages

TOKYO: Japanese police rescued four hostages from a bank on Friday and arrested the knife-wielding man who had held them captive for more than 12 hours while demanding the prime minister resign, officials said.

In a televised news conference, a police spokesman said the hostage-taker, identified as Koji Nagakubo, was arrested on suspicion of taking a total of five people captive, including one person whom he had released earlier.

All the hostages were safe and in protective custody following the pre-dawn police raid, the spokesman said, though local media reported one of them -- a 19-year-old female bank employee -- was slightly injured.

The 32-year-old man began the siege on Thursday afternoon at the Zoshi branch of the Toyokawa Shinkin Bank in the otherwise quiet residential area of Toyokawa city in central Aichi prefecture.

Wielding a survival knife, he took four employees and a female customer captive and demanded the cabinet of Prime Minister Yoshihiko Noda step down, local media said. Noda last week called an election for December 16, which he is expected to lose.

In initial questioning by police, the suspect admitted the allegations but had yet to give details about his motive, public broadcaster NHK reported.

About 13 hours after the incident began, police wearing protective gear and carrying shields rushed the office before dawn, overpowered the man and escorted out the remaining four hostages.

"It was difficult to check inside, but we took action placing top priority on the safety of the hostages," an investigator told NHK. "We believe we took the best possible way."

Television footage showed a dozen police breaking the window on the second floor before moving to the ground floor, where the man pointed his knife at the hostages.

The man, who also held another knife, handcuffed at least one of the hostages, NHK said, adding that all police involved in the rescue operation were also unhurt.

"I was so relieved because no one was (seriously) injured," one neighbour told Tokyo Broadcasting System Television.

Television footage earlier showed a man who appeared to be a police officer carrying a megaphone and a plastic bag to a side door of the building guarded by police. The building's shutters were down but lights could be seen inside.

Shortly before the incident, a man police believe was the hostage-taker had attempted to break in another bank just 150 metres (yards) away from the site, NHK reported.

- AFP/xq

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Congress withdraws second list of candidates in Gujarat after protests

NEW DELHI: Resentment in Congress ranks over ticket distribution for Gujarat elections broke out in the open, forcing the party to withdraw its second list of 46 candidates released late on Wednesday night.

The anger in Congress was evident when party MPs engaged heir apparent Rahul Gandhi in animated discussion in Parliament in the presence of the head of the screening committee and Union minister C P Joshi.

The discontent was evident with a Union minister from the state saying early in the day that the party had put the list on hold. The decision was announced only in the evening. He said the names of candidates may undergo serious changes after the protests.

Congress is locked in a lopsided battle with BJP headed by Narendra Modi in Gujarat and protests over nominations do no augur well for the party. Even the first list of 52 candidates led to protests and resignations in Ahmedabad.

Congress leaders conceded that the party had failed to build momentum despite favourable factors like rebellion by BJP veteran Keshubhai Patel. The selection of candidates was said to have been the final weapon to rally opinion in its favour but the initial reaction has disappointed the party.

An agitated Congress MP threatened to walk out of the party and even "expose" senior leaders for doing the bidding of an industrial house by "planting" candidates.

He said the partnership with NCP was being used to settle scores with in-house aspirants. NCP general secretary D P Tripathi said the junior partner was allocated nine of the 182 seats in the state.

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2 Dead, Dozens to Hospital After 100-Car Pileup

At least two people died and more than 80 were injured after a 100-plus car pileup in Texas today, according the Department of Public Safety.

A man and a woman died from their injuries, ABC News affiliate KBMT-TV reported. Their names were not immediately available.

The DPS said it won't know the exact number of cars involved in the pileup until officials finish untangling the wrecks.

At least five people who were taken to the hospital are in critical condition, KBMT reported.

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The accident happened in Jefferson County shortly after 8 a.m. Thanksgiving morning on Interstate 10 between Taylor Bayou and Hampshire Road.

Fog blinded drivers, with investigators saying most couldn't see a foot in front of them at the time of the crash.

"The cause of the accident was a heavy fog bank rolled into this area this morning, which caused nobody to be able to see and caused one accident that triggered another accident and then a chain reaction," said Deputy Rod Carroll of the Jefferson County Sheriff's Department.

"Even as the deputies were pulling up we still had a continuous chain of accidents," Carroll said.

An 18-wheeler tanker truck began leaking after the chain-reaction accident, KBMT reported.

The eastbound side of the freeway was closed for hours and remained closed into the afternoon, DPS told ABC News. The westbound lanes opened shortly after noon.

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Study finds mammograms lead to unneeded treatment

Mammograms have done surprisingly little to catch deadly breast cancers before they spread, a big U.S. study finds. At the same time, more than a million women have been treated for cancers that never would have threatened their lives, researchers estimate.

Up to one-third of breast cancers, or 50,000 to 70,000 cases a year, don't need treatment, the study suggests.

It's the most detailed look yet at overtreatment of breast cancer, and it adds fresh evidence that screening is not as helpful as many women believe. Mammograms are still worthwhile, because they do catch some deadly cancers and save lives, doctors stress. And some of them disagree with conclusions the new study reached.

But it spotlights a reality that is tough for many Americans to accept: Some abnormalities that doctors call "cancer" are not a health threat or truly malignant. There is no good way to tell which ones are, so many women wind up getting treatments like surgery and chemotherapy that they don't really need.

Men have heard a similar message about PSA tests to screen for slow-growing prostate cancer, but it's relatively new to the debate over breast cancer screening.

"We're coming to learn that some cancers — many cancers, depending on the organ — weren't destined to cause death," said Dr. Barnett Kramer, a National Cancer Institute screening expert. However, "once a woman is diagnosed, it's hard to say treatment is not necessary."

He had no role in the study, which was led by Dr. H. Gilbert Welch of Dartmouth Medical School and Dr. Archie Bleyer of St. Charles Health System and Oregon Health & Science University. Results are in Thursday's New England Journal of Medicine.

Breast cancer is the leading type of cancer and cause of cancer deaths in women worldwide. Nearly 1.4 million new cases are diagnosed each year. Other countries screen less aggressively than the U.S. does. In Britain, for example, mammograms are usually offered only every three years and a recent review there found similar signs of overtreatment.

The dogma has been that screening finds cancer early, when it's most curable. But screening is only worthwhile if it finds cancers destined to cause death, and if treating them early improves survival versus treating when or if they cause symptoms.

Mammograms also are an imperfect screening tool — they often give false alarms, spurring biopsies and other tests that ultimately show no cancer was present. The new study looks at a different risk: Overdiagnosis, or finding cancer that is present but does not need treatment.

Researchers used federal surveys on mammography and cancer registry statistics from 1976 through 2008 to track how many cancers were found early, while still confined to the breast, versus later, when they had spread to lymph nodes or more widely.

The scientists assumed that the actual amount of disease — how many true cases exist — did not change or grew only a little during those three decades. Yet they found a big difference in the number and stage of cases discovered over time, as mammograms came into wide use.

Mammograms more than doubled the number of early-stage cancers detected — from 112 to 234 cases per 100,000 women. But late-stage cancers dropped just 8 percent, from 102 to 94 cases per 100,000 women.

The imbalance suggests a lot of overdiagnosis from mammograms, which now account for 60 percent of cases that are found, Bleyer said. If screening were working, there should be one less patient diagnosed with late-stage cancer for every additional patient whose cancer was found at an earlier stage, he explained.

"Instead, we're diagnosing a lot of something else — not cancer" in that early stage, Bleyer said. "And the worst cancer is still going on, just like it always was."

Researchers also looked at death rates for breast cancer, which declined 28 percent during that time in women 40 and older — the group targeted for screening. Mortality dropped even more — 41 percent — in women under 40, who presumably were not getting mammograms.

"We are left to conclude, as others have, that the good news in breast cancer — decreasing mortality — must largely be the result of improved treatment, not screening," the authors write.

The study was paid for by the study authors' universities.

"This study is important because what it really highlights is that the biology of the cancer is what we need to understand" in order to know which ones to treat and how, said Dr. Julia A. Smith, director of breast cancer screening at NYU Langone Medical Center in New York. Doctors already are debating whether DCIS, a type of early tumor confined to a milk duct, should even be called cancer, she said.

Another expert, Dr. Linda Vahdat, director of the breast cancer research program at Weill Cornell Medical College in New York, said the study's leaders made many assumptions to reach a conclusion about overdiagnosis that "may or may not be correct."

"I don't think it will change how we view screening mammography," she said.

A government-appointed task force that gives screening advice calls for mammograms every other year starting at age 50 and stopping at 75. The American Cancer Society recommends them every year starting at age 40.

Dr. Len Lichtenfeld, the cancer society's deputy chief medical officer, said the study should not be taken as "a referendum on mammography," and noted that other high-quality studies have affirmed its value. Still, he said overdiagnosis is a problem, and it's not possible to tell an individual woman whether her cancer needs treated.

"Our technology has brought us to the place where we can find a lot of cancer. Our science has to bring us to the point where we can define what treatment people really need," he said.

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Online:

Study: http://www.nejm.org/doi/full/10.1056/NEJMoa1206809

Screening advice: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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