Monday, November 23, 2009

Fact-free breast cancer discussion

The kerfluffle over the new mammogram and pap smear guidelines has emphasized for me the remarkable lack of facts in the public discussion about most things.  Before deciding whether to be pissed off about these guidelines, I think there are lots of things you'd have to know:  Is there some kind of standard way for assessing whether a screening test is worthwhile?  Was that used here?  Are there actual health risks to getting a biopsy that turns out to be a false positive?  It seems weird that they would say unnecessary "anxiety" was a reason not to screen people, because in weighing anxiety vs. death, anxiety seems like not a biggie; does "anxiety" always factor into recommendations about health screenings?  How is it weighed?  (1000 anxious people > 1 dead person?)  There was a lot of attention paid to the fact that these new guidelines didn't consider cost; but (while they're at it with considering anxiety) shouldn't they throw in money too? 
Admittedly I did not spend all weekend looking for the answers to these questions, but I didn't see the answers to ANY of them in anything I read.  Instead there were hours of Sunday talk shows with people yelling crap at each other about rationing, their family members who got breast cancer, and the general idea of "science," but nothing about what that means. 
Of course, when I have to make a decision about something like at what age I will start getting mammograms, I will probably make the decision in a totally impressionistic way, and will actually limit the amount of information I try to find out because the more information, the more confusing it will be.  But I would like to think that somebody would know that information.  Perhaps this is one of those disillusioning things about becoming a grownup.  :( 

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