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Decisions about mammography

Whether mammography for women aged between 50 and 69 is a good idea is still not a clear-cut issue. A paper in this week’s BMJ looks at age-specific outcomes and concludes that the benefits and harms of screening are finely balanced.

The potential harms include anxiety, which may be long-lasting, caused by false positive results and the psychological and physical impact of detection and treatment of disease that would not have caused any problems if left untreated. (Very similar considerations apply to prostate cancer screening for men.)

In essence the decision to be screened is a gamble; there is only a small chance of benefit but the stakes are high. Some women will choose the gamble even though they may experience anxiety, inconvenience, and physical adverse effects; other women will not.

Reference: Barrat A et al., Model of screening mammography: information to support informed choices. BMJ 2005;330:936-8.


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