Everything you thought you knew about mammograms is wrong. A new gold-standard study out of Canada looked at the effect of mammograms by randomly assigning women to two different groups: one who got mammograms and one who didn’t. The results call into question the entire value mammograms for women today. The NYT has the story:
[The study] found that the death rates from breast cancer and from all causes were the same in women who got mammograms and those who did not. And the screening had harms: One in five cancers found with mammography and treated was not a threat to the woman’s health and did not need treatment such as chemotherapy, surgery or radiation […]In the United States, about 37 million mammograms are performed annually at a cost of about $100 per mammogram. Nearly three-quarters of women age 40 and over say they had a mammogram in the past year. More than 90 percent of women ages 50 to 69 in several European countries have had at least one mammogram.
Mammograms not only are no longer helpful in catching breast cancer: they actually have positive harms and cost US healthcare important time and money. This new experiment dovetails nicely with other recent studies—such as in Oregon—showing that expanded insurance does not have a direct or clear relationship to health. The fundamental truth emerging from much recent work on the US health care system is that health, health care, and health insurance are all three different things. They bear important relationships, of course. But those connections are complex and understudied. We do know that neither health care nor health insurance as we currently use them always improve health. We also know that health is a multifaceted phenomenon that has as much to do with environmental factors or your relationships to other people as to the treatment you receive. But there’s a lot we still don’t know, and that makes policies based on the folk notion of a direct progression from health insurance to health care to health outcomes problematic.