An interesting article was published in the latest Lancet: Use of a decision aid including information on overdetection to support informed choice about breast cancer screening: a randomised controlled trial.
In brief, women who got information about the risk and possible harms of breast cancer screening (by mammography) were less likely to intend to be screened. The study didn't go on to look at what the women actually chose (only what they intended to choose). However, it still confidently suggests that women who have all of the information are less likely to get screened.
Contrast this informed approach with the classic approach from the well-intentioned doctor: "You need a mammogram to screen for breast cancer. Here is the requisition."
It is not wrong to say no. (These are the words of Dr Iona Heath - well ahead of the curve - in the title of a BMJ paper in 2009 regarding this same topic).
It is not wrong to say no. And the more you know, the more likely you'll say no.
Not sure what to do for yourself?
Not sure how to start discussing this with patients?
- Here is a Canadian resource to help you decide if Mammography is right for you; it's not perfect but it is a start
- Below is an icon array from the Harding Center for Risk Literacy that helps visually represent the benefits vs. harms of mammography: