all those mammograms you may have had look like a waste of time. And for all of us who picked up the message that if you didn’t get a yearly mammogram after 50, then you were asking for it? Forget that too. Now it is every other year. In the US, of course.
(I apologize for the irritated tone on this important topic, but it is important too that we have a pretty clear example of adamant advice that was based on less than good data and understanding.)
Actually, the new recommendations reflect the fact that the contribution of regular mammograms to women’s health and longevity looks pretty problematic in a number of ways. There has been over-treatment, apparently (see update). So what one needs to do is to forget the urgency and have a heart to heart with one’s gynecologist. Though just how tailored the advice a doctor gives to her clients in a large practice is will be another question to ask. And without wanting to complain from ignorance, I don’t know why we should think in advice that the parameters for a decision are so complex that we have to seek expert opinion, as opposed to perhaps some agreement. Of course, the advice is not going just to PhDs, but women are not bad at assessing their degree of understanding.
This all comes from a very influential committee; here is the advice:
Women in their 40s should not get routine mammograms for early detection of breast cancer, according to updated guidelines set forth by the U.S. Preventive Services Task Force.
“All we are saying is, at age 40, a woman should make an appointment with her doctor and have a conversation about the benefits and harms of having a mammography now versus waiting to age 50,” said Dr. Diana Petitti, vice chair of the task force.
Before having a mammogram, women ages 40 to 49 should talk to their doctors about the risks and benefits of the test, and then decide if they want to be screened, according to the task force.
For women ages 50 to 74, it recommends routine mammography screenings every two years. Risks and benefits for women age 75 and above are unknown, it said.
The group’s previous recommendation was for routine screenings every year or two for women age 40 and older.
The task force is composed of 16 health care experts, none of whom are oncologists. The group reviews medical data and bases recommendations on effectiveness and risks involved.
Since this group advises doctors and insurance companies, it may well affect what one can claim for.
Of course, the evidence is statistical and it may be the case that the mammogram was essential in saving some young peoples’ lives. I know the cliches one is suppose to say here about exceptions not making good policy, but still…
Update: From NPR, on 11/16: The American Cancer Society still recommends yearly mammograms after 40. The descriptions of over treatment varied, with one person at one point talking about women unnecessarily receiving chemotherapy and radiation. The most frequent worry expressed was, however, that there are a large number of false positives that resulting in much unnecessary anxiety. Unnecessary anxiety, as one person said, hardly seems a reason to decide for women what we need.
Do see SallyH’s comment!