Whether the cost is worth it or not comes down to two levels. First and foremost, what matters is the woman being screened, what she values, and what her tolerance is for paying the price of screening at an earlier age, such as a high risk for overdiagnosis, excessive biopsies, and overtreatment in order to detect cancer earlier and a relatively low probability of avoiding death from breast cancer because of screening. Then there’s the policy level, where we as a society have to decide what tradeoffs we’re willing to make to save a life that otherwise would have been lost to breast cancer. Although screening programs and recommendations should be based on the best science we currently have, deciding upon the actual cutoffs of who is and is not screened and how often unavoidably involves value judgments.
That’s putting it well. Somewhere in the comments on the post, he also states that he wishes the whole “anxiety” thing weren’t being so generally overplayed. That I agree with as well, since it’s the thing that many women have grabbed on to, and it also the source of the accusations that the recommendations are “patronizing.” Considering that the detrimental effect of anxiety is not being played up in the recommendations, but rather that’s coming from the reporting, I think it’d be more fair to say that the press is being patronizing. Which isn’t a surprise for anyone.
Anyway, a good post. And unlike me, Orac knows what he’s talking about. His second post on the subject is also very worth reading.