Let me try to explain my perspective in a different way:

By way of analogy to USPSTF recommendations on screening, let’s imagine a socio economic group that on average does poorly in higher education. If we followed the “task force” approach of the USPSTF we would say, let’s not waste money and resources trying to educate these folks — look at how bad the outcomes are for so many of them. Is that really the world we want to live in or should we see how to create more successful outcomes. The same goes with screening in my opinion. It clearly provides important life defining information for some of us — so why is USPSTF so ready to throw us out as meaningless exceptions? It would seem to me that the successes, even if a minority, prove the worth of screening and USPSTF should study those and compare them to the failures, and then draw conclusions as to what to do right, rather than trying to reduce screeing because of the failures. If you had the unfortunate experience of being diagnosed with breast cancer or prostate cancer, would you go to the USPSTF to get an opinion on what to do next? Of course not, because they only deal with statistics and averages. We all seek ways to be above average and to raise the average. If you want to be average and bellow, follow the USPSTF suggestions. However if you want to be treated as a unique individual, and to get the best possible treatment, and to have your own variations in diagnosis and disease taken into account go to specialists in the disease, several for a range of opinions. Read up all you can, check out the latest research papers (scientific papers with specific details of the patients, treatments, etc , not mass undifferentiated outmoded population surveys.

I think you are missing the point. Finding someone to “fix the odds” is not how it works. Simply put, the USPSTF looked at large studies and devised these rec’s. Going to a so called “expert” will either follow his/her interpretation of this data or more likely his/her own intuition. As reflected in the recent NYT article about Intermountain, physicians often use recent experience to determine their practice. It is simply human nature. For example, if I diagnosed a patient with breast cancer in their 40’s and she was “cured,” I will be much more likely to recommend screening to a patient than a colleague without that same experience. It is human nature.

The point of these rec’s is to remove a physicians bias from screening rec’s to which I say “Good Job USPSTF!”

In residency, we are taught by so called to “experts” to ignore the experts and focus on the data. Expert opinion is considered level III data (certainly nothing to hang your hat on).

There is a growing amount of evidence that every cancer isn’t deadly. If a cancer is found, current medical understanding doesn’t know which cancers kill, which ones grow so slowly that they would never be an issue, and which ones will go away on their own. Prostate cancer screening is facing similar issues.

So much for tissue confirmation if medicine can’t tell me if the cancer is fatal or will go away on its own.

But that IS what the supporting documents state. Though it goes against our basic instincts, early detection of many cancers does not increase life span. This is becoming especially clear for prostate cancer, and to some degree for breast cancer. The cancer is detected early, meaning that the patient is subjected to more years of aggressive and unpleasant treatment, with no prolongation of lifespan.

Lots to think about here!

Women need to be given accurate information of the potential harms, whatever they are, and decide whether the benefit justifies the risks.

Ultimately, women will be given no choice but to pay for the test. The suggestion that after discussion with a physician a woman has a choice under the new guidelines is misleading. If routine screening is not recommended why would a physician have such a discussion? And after discussion there is no reason except the desire to have the benefit of screening, isn’t that the very kind of screening the recommendations are calculated to prevent?