Friday, January 15, 2016

2016 USPSTF breast cancer screening recommendations

The latest recommendations are finally out.

I have a beef with its recommendation for the 50-74 age group: They base their decision on the fact that reviews of studies show a decreased breast cancer mortality in those screened. However, the task force clearly knows that screening does not reduce deaths from all causes. They say so right there in their statement: "None of the trials nor the combined meta-analysis demonstrated a difference in all-cause mortality with screening mammography."

What does this mean? Well, apparently screening programs do reduce the number of breast cancer deaths (within a specified time period, eg. per year) but then increases the deaths from other causes, thus nullifying the reduction in the breast cancer mortality. So some women will not die from from breast cancer while others get the short end of the stick and die from something else instead.

So why recommend screening when it does not affect death rates from all causes? Why not underscore this vital information, make certain women know about it, and then have them decide whether they want to go through a screening regimen to reduce their risk of dying from breast cancer but then increase their risk of dying from other causes?

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