WHAT ARE YOU LETTING IN THROUGH THE SCREEN DOOR?:

Benefits of Mammogram Under Debate in Britain (RONI CARYN RABIN, 3/30/09, NY Times)

The conventional wisdom about breast cancer screening is coming under sharp attack in Britain, and health officials there are taking notice.

They have promised to rewrite informational fliers about mammography after advocates and experts complained in a letter to The Times of London that none of the handouts “comes close to telling the truth” — overstating the benefits of screening and leaving out critical information about the harms.

What women are not told, the letter said, is that for every woman whose life is saved by breast cancer screening, up to 10 healthy women are given diagnoses — and, often, surgery — for a cancer that is so slow-growing it would never have threatened a woman’s life. [...]

Ultimately, women have to make their own decision about whether to be screened, said Dr. Lisa M. Schwartz, an associate professor at Dartmouth Medical School, who is co-author of “Know Your Chances” (University of California, 2008), a book about how to interpret health statistics and risk.

“You’re not crazy if you don’t get screened, and you’re not crazy if you do get screened,” said Dr. Schwartz, who also signed the letter to The Times. “People can make their own decision, and we don’t need to coerce people into doing this.

“There is a real trade-off of benefits and harms. Women should know that. There’s no question on one count: if you get screened, it’s more likely you’ll have a diagnosis of breast cancer.”