Gina Kolata continues to cover the whole cancer screening thing with great skill. In this outing, she covers the latest recommendation out of the US Preventive Services Task Force, which is a reversal of their recommendation in 2002 for women in their 40s to get mammograms every two years. The new recommendation is to start at 50.
This is really great, and here's why: it's an example of how we can save money AND treat people better. The risks associated with screening are substantial (starting with the risks of unnecessary treatment, continuing through the added doses of radiation, and then sliding through all the anxiety from there) and the benefits so tiny as to be difficult to measure. If you know someone whose cancer was detected and treated early as a result of a mammogram screening, the odds are fantastically good that that treatment wasn't necessary.
Predictably, people who benefit from mammograms (that is, the people who make money off of them) aren't happy about this and are sticking with the old recommendations.
From Dr. Berg, the chairman when they issued the recommendation to do screenings starting at 40:
"Different women will weigh the harms and benefits differently, Dr. Berg noted, but added that even for women 50 and older, “it would be perfectly rational for a woman to decide she didn’t want to do it.”"
From a statistician who worked on the data recently:
"Of course, Dr. Berry noted, if the new guidelines are followed, billions of dollars will be saved. “But the money was buying something of net negative value,” he said. “This decision is a no-brainer. The economy benefits, but women are the major beneficiaries.”"
This is going to be a tough sell. No one wants to think they had a double mastectomy for no damn good reason. That said, the numbers involved do not apply to women who have BRCA1 or 2.