Mammogram screening divides doctors and patients

Mammogram screening for breast cancer continues to simmer in the news.

The recent USPSTF guidelines, no longer recommending a routine mammogram for women between the ages of 40 and 49, continue to stir controversy between physicians and their patients.

In a recent survey from the Annals of Internal Medicine, it looks like the debate between doctors and patients will continue for the foreseeable future:

. . . a divide has emerged between doctors and patients — with the doctors more inclined to accept the new recommendations and the patients wanting to stick to early and annual screening . . . Most of the 345 doctors who responded said they would stop offering routine mammograms to women in their 40s, and most said they would advise women 50 to 74 to have mammograms only every other year . . .

. . . most of the 241 patients who responded said they did not believe in giving up routine mammograms in one’s 40s — even if the doctor recommended a change — and were not likely to switch to an every-other-year routine.

This is entirely unsurprising. There continues to be a perception among patients that more screening and tests equate to better health care — despite the evidence that says otherwise. False positives that arise from more aggressive screening can lead to more harm than good.

The media firestorm caused by mammogram screening is a good first step to educate the public that there indeed can be such a thing as “too much” medicine.

Policy experts and health reformers tend to blame the medical profession for American’s embrace of expensive and unnecessary tests. Instead, they should help find ways to help doctors educate patients and reduce the demand for these studies.