I think no further look at evidence will resolve the screening mammography question. This is a question of VALUES and how we weigh false positives (unnecessary
biopsies, surgeries etc- regret of commission, of unnecessary) vs. false-negatives (missing cancer, delay in diagnosis, etc- regret of omission, of potentially failing to save lives). Because our risk attitudes inherently differ (there is no such a thing as
“right” or “wrong” risk attitude), no guidelines panels can make recommendation for a woman facing decision whether to accept invitation to screening mammography.
This is best summarized by Lesley Fallowfield in one of the papers to which Ash provided links provided below, and Fiona Godlee in her editorial when she says
that she “speaks for many women when she admits that, despite her own detailed knowledge of the science, she is uncertain of the value of mammography screening. “I feel silly for attending screening, but scared not to do so.”
Ben Djulbegovic
From: Evidence based health (EBH) [mailto:[log in to unmask]]
On Behalf Of Ash Paul
Sent: Friday, November 25, 2011 1:47 AM
To: [log in to unmask]
Subject: Re: New breast cancer screening guidelines released Canada_underscoring the need for decision making based on evidence