Breast Cancer Screening: Let Evidence Trump Fear

“Breast Cancer Screening: Let Evidence Trump Fear,” by Lisa Simpson and Shannon Brownlee, Health Affairs Blog.

The United States Preventive Services Task Force’s latest draft report on the potential benefits and harms of mammography screening was met by outcries from radiologists and others that thousands of women would die if the recommendations were followed. The Task Force concluded that women between the ages of 50 and 74 should get mammograms every two years. But for women under 50, the chances that a mammogram will help her rather than harm her are very small. For younger women, the decision to get a mammogram should be made on a case-by-case basis.

This is reasonable advice, but you wouldn’t know it from comments on Twitter and in some media outlets. There is growing evidence of over-diagnosis and over-treatment. Patients need access to high quality, evidence-based decision aids about mammography. Physicians need to engage in truly shared decision making. Women and their doctors need to understand that more screening is not always better.

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