From Aaron Carroll, responding to the deluge of lame criticisms aimed at a recent study showing that mammograms don’t do much to reduce mortality from breast cancer:
I leave you with one final thought. If you’re not going to be swayed at all by a randomized controlled trial of 90,000 women with 25 year follow up, excellent compliance, and damn good methods, it might be time to consider that there’s really no study at all that will make you change your mind.
This really has taken on the nature of a religious war. But eventually we have to face facts. If you have a family history of breast cancer, or some specific markers of vulnerability, or if your doctor thinks you need one, then of course you should get a mammogram. But despite what we’ve all been taught for the past several decades, the evidence is becoming overwhelming that a blanket recommendation of routine annual mammograms for everyone over the age of 40 just isn’t good medicine. This isn’t coming from people who are anti-woman or who are just trying to slash budgets. Nor is anyone saying that mammograms are useless. That just isn’t what’s happening.
What’s happening is routine science. And unlike religion, the answers change now and then when you do routine science. That’s sometimes uncomfortable and sometimes scary. But that’s the story here. Right now, the answers are changing, and we need to change along with them.