When Less Is More: Some Health Screenings Deemed Risky

Evidence-based medicine says certain health screens don't help, might hurt

Wednesday, November 18, 2009

A government-backed physicians' group, the U.S. Preventive Service Task Force, recommended this week that women delay their yearly breast exams until age 50. (Previously, 40 was the suggested age to begin screening.) The recommendation has quickly sparked a national debate. People intuitively feel that more tests are always better, but health economists and doctors practicing "evidence-based medicine" say that some screenings aren't worth doing as often: They don't actually help many patients, they expose millions to risks from radiation, and they can lead to expensive, unnecessary treatments for patients who wouldn't otherwise get sick.

Mary Elizabeth Williams is The Takeaway's culture critic and a writer for Salon.com. She's been getting mammograms for years even though she's noticeably younger than the new recommended cutoff age...but she has no plans to stop. We also talk to Michael Chernew, a professor of health care policy at Harvard Medical School. Economists like Chernew run the numbers that lead to some of these controversial suggestions. And Dr. Gerald Andriole, professor and chief of urology at Washington University in St. Louis, does prostate screenings – yet another preventive-care practice now under scrutiny for its evidence-based results.


Dr. Gerald Andriole, Junior, Michael Chernew and Mary Elizabeth Williams


Noel King and Matt Lieber

Comments [2]


Mary Elizabeth Williams might be making a dubious medical choice, but she probably feels that it is her choice nonetheless. And I like the idea of her making choices about her own healthcare. So it is all the more ironic that liberals like the Saloniks of which Ms. Williams is typical (archetypical in the case of Salon) would support our moving toward a system of healthcare in which everyone is taxed to fund a national health care system in which a government is likely to side with evidence-based practice and try to cut costs wherever possible. A bureaucrat is the one likely to be making your decisions in the future about your screening mammograms, Ms. Williams. So welcome to the fight against Obamacare.

Nov. 18 2009 02:16 PM
Richard Johnston

Resistance to following this advisory is further, alarming evidence that people don't even trust science these days. Ready access to countervailing advice, irresponsible as it may be, is one of the causes. This is another reason medical costs are so high.

Nov. 18 2009 09:08 AM

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