If, after reading the latest recommendation on breast cancer screening by the United States Preventive Services Task Force (USPSTF), you feel like your head is spinning, that’s understandable. The task force’s newest advice, which gives a “B” grade in favor of routine mammograms for women in their 40s, reverses its 2016 statement saying the test should be optional for such women. And that 2016 opinion conflicted with earlier task force recommendations.
Why has there been such zigzagging when it comes to screening younger women for signs of hidden breast cancer? It’s not that the data keep changing between task force recommendations. Instead, as with other groups using evidence-based medicine, task force reviews emerge from complicated analyses and discussions of data by experts with individual opinions about what the data do and do not show. Although this subjectivity might appear to be contradictory to evidence-based medicine, it is an inevitable part of it. And it is why the evaluation of complicated tests such as mammography remains tricky — and sometimes frustrating to the people who might need it.
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Author: Barron H. Lerner
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