The United States Preventive Health Task Force’s new recommendations for mammogram and breast self-exam use have stirred up an interesting debate. In a nutshell, the Task Force no longer recommends routine mammogram use among women aged 40-49; nor do they recommend teaching breast self-exams as a method of detecting cancer.
Many people believe that these recommendations will increase preventable deaths. This may be right for some situations, but it doesn’t consider the whole picture. To really understand the problem, we need to know more than how many women are saved by mammograms. We also need to know how many women die because of mammograms.
There are a lot of ways that having a mammogram, or any medical procedure, can cause death or serious illness – called iatrogenic harm. One of the most interesting arguments I’ve come across on this topic is the risk that rural women may face when trying to get recommended mammograms.
Since rural women live, by definition, in areas with limited health care services, they often have to travel for 300 or more miles to get their mammograms. If women make a special trip to get this screening, then they are placing themselves at increased risk for death or severe injury as a result of a car crash.
It has been estimated that between 2.6 and 34.7 severe car crashes (defined as a crash where at least one person is killed or injured) occur for every life saved by mammography among women aged 50-69 in rural Ontario, Canada.
2.6 to 34.7 severe crashes per every life saved by mammography.
It’s certainly something to think about.
[...] Presumably the task force used these results to weigh the benefits of mammography against potential negative implications to health of having a positive mammogram result but not having cancer in making their recommendations. Although maybe not all potential negative implications. [...]