Which women should get a mammogram for breast cancer screening?

What a great question!  This morning, Ted Ganiats, MD gave a great lecture on cancer screening at the KU Winter Symposium.  He compared the US cancer screening recommendations with their European counterpart reccomendations.

A few quick highlights:

  • Europeans screen for colon cancer exclusively with FOBT and it has the same cost efficacy slope as colonoscopy
  • 1 death is prevented from 13,000 mammograms in women over 50
  • Women from 40-50 probably shouldn’t get a screening mammogram
  • Europeans don’t even screen for prostate cancer because the evidence is lacking

The best evidence based guidelines have these qualities:

  1. Level of evidence
  2. Benefit
  3. Harm
  4. Cost
  5. Value Judgments
  6. Patient preference
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