There have been plenty of posts debating the wisdom of the recent breast cancer screening guidelines.

The New York Times has some of the best stuff, explaining the rationale of the decision, with a good discussion on the math and statistics surrounding the issue. Here’s an example in an article entitled, Mammogram Math.

But it goes beyond the public not accepting empirical evidence.

Another piece from economist Richard H. Thaler again tries to explain the data, but it’s likely going to fall on deaf ears. People generally already have their entrenched beliefs, and only seek information that already affirms a pre-conceived mentality.

Furthermore, as Mr. Thaler writes, our system isn’t really set up for such nuanced discussions:

It is safe to say that our current medical care system is not designed to do well at making these decisions. Careful medical and scientific recommendations are turned into political footballs, and doctors are often paid for testing and treating and run the risk of being sued or rendered guilt-ridden for not doing so.

Great paragraph. Decisions about cancer screening have to be individualized, and cannot be made from mass screening guidelines.  Not in our society, anyways.

There’s currently not enough incentive for doctors to discuss these decisions with every patient. Until we find a way to do so, there’s little hope that both patients and doctors will follow guidelines based on the best available evidence.