First, it's more than just 0.7:33. It's 470 false positives and the anxiety and worry that goes with those. But the whole point of the report is that it is a guideline. Their advice is to use it as a guideline and for each individual to discuss with their doctor to make an informed decision. So if the individual prefers extra screening, they can do it. If they don't, then they don't have to. I don't think it's a matter of "what else can you do", I think these studies and report provide extremely valuable information. I also think a big issue is that many people assume there is no downside to an extra screening (except perhaps cost). A report like this highlights the potential drawbacks and encourages discussion. It also encourages confusion, which as they admit is the big downside, but that is a necessary evil of adjusting recommendations when new data is reviewed. I'd rather take the less than 1 in 1000 chance at dying than take countless tests that are unlikely to help me.
This is a very complicated issue where thoughtful people can come to different conclusions. Of course clowns like basso and the rest of wingnuttia will do their best to make sure no reasonable discussion takes place by screeching about "breast panels" and "Obamacare".
Of course I'd say no. That's the whole point. I don't want my wife, mother, sister or daughter to go through the unnecessary anguish of the almost likely false positive (or even the anguish of waiting for results) for the completely unlikely possibility that skipping the screening will cost them their life. I don't think you'd say yes either, unless you're misunderstanding the proposition. Do you do every possible preventative checkup for yourself and your family all the time, even if the chances they will help are one in a million? No, you probably don't. That's what I was talking about in the part you quoted.
You wrote this: I'm guessing another 0.01 life will be saved (per 1000) or something like that. Is that really worth it though? I would hope you'd say no. I replied that what if that life was your mother, daughter, sister or wife. Would you want that life saved? You just replied NO. Do you understand what you just wrote?
Of course I understand what I just wrote. The answer is still no. Sorry if my logic confuses you, but it's a pretty easy decision for me. Let's say, just for the sake of argument, that performing every preventative test known to man once a day every day would save 1 life for every 100 million people who do it. Now, what if that one person was your wife or mother or sister or daughter. Would you want that life saved? If yes, then why aren't you insisting that your loved ones get every preventative test available done every day, just in case it turns out that they are that one in 100 million?
I'll simply deal in real world scenarios. I am just suprised that anyone would prefer that a loved one would die of a preventable/treatable disease rather than undergo a reasonable test (yearly mammogram).
The 1 life uolj was talking about is someone who is not a woman over 40. The real world scenario is women over 40 (or 50) should get tested. What is not real world is blanket-testing men and women under 40 to prevent the very rare case of breast cancer in those populations. The line between due caution and overtesting must be drawn somewhere. It is possible that 50 or 40 or some other age is the appropriate age to start testing as a matter of public health policy. His wife might be that 0.7 in 1000 between 40 and 50 that dies because of a decision to not screen. His 5 year-old son might be the 1 in a million that dies because we don't routinely test boys for breast cancer. You've got to draw the line somewhere.
Another aspect of this if you want to bring this back into the healthcare argument, is that the new republican argument is that we could cut uncessary preventive care costs with tort reform. Now the argument is that doctors perform all these unecessary tests driving up healthcare costs for the fear of being sued. I don't think it makes sense because the doctors will always have that liability hanging over their head but that's another thread
Except though this is a change to previous guidelines. So what makes the previous ones more correct than the new guidelines?
I guess you did misunderstand me. The scenario I was talking about was not a yearly mammogram, although the same concept applies. The "I would hope you'd say no" comment was in reference to everybody getting mammograms. JuanValdez articulated the point nicely. Do you think it's reasonable to have all people get yearly mammograms regardless of age and gender? I don't, even if it could save one life in a million. And my hypothetical is based on a real world scenario. I'm really curious to hear your answer. Don't you think that if every person had every possible preventative test performed every day, that at least one life in a 100 million would be saved? And if so, either you should be promoting the use of every possible preventative test every day, or you acknowledge that a line has to be drawn somewhere, even if there is a chance that the one in 100 million person turns out to be your loved one. The scenario is exaggerated on purpose, but it is still a real world question.
