• Harm from mammograms?

    We had an excellent call on Stand Up! with Pete Dominick today where an oncologist wanted to counter some of what I said about the necessity of mammograms for women in their 40s.  He brought up a couple of points worth repeating:

    1)  There was no oncologist on the panel making this recommendation

    I don’t dispute this.  I think that the recommendations would have been stronger with an oncologist’s voice involved.  However, I don’t believe that this invalidates the findings.  The USPSTF is a group of researchers and experts in evidence based medicine evaluating research (much of which was performed by oncologists).

    2) The amount of harm from radiation is minimal

    Again, no dispute.  Although the actual amount was underestimated on the radio, it’s still not a ton.  What I didn’t get to say on air, however, is that there is harm from false positives in mammograms.  When the likelihood of disease is low (and it is for a woman in her 40s), a positive test is more likely to be benign than malignant.  Many women have to undergo further testing, and sometimes surgery, because of false positive tests.  That’s the true harm.

    3) There is some (minimal) benefit to mammograms for women in their late 40s.

    Again, I’m not arguing.  I just agree with the panel that the harms likely outweigh the benefits in this age group.

    Notice I haven’t even brought up costs (which are significant).

    Now remember that none of this outlaws mammograms or prevents someone who wants one from getting one.  It’s just a recommendation on whether there should be universal screening.  It’s not socialism or fascism or anything else.  Please don’t make this political.  The system is already pretty bad without adding that to it.

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