I don't really wonder that a lot of people are confused by the media treatment of this week's announcement about mammograms, and clearly the unnamed Courier editor is among them. There are a couple of factors involved in this that shouldn't be, and they muddy the water considerably.
The first is that this is a science story, an area where we can count on our journalists to fail us pretty generally. Start talking about random trials, control groups and methodologies and their eyes instantly glaze over. They just want the bottom line, and they have a hard time remembering that the conclusion of a scientific study does not constitute a fact, but rather the best estimate the scientists can get of the truth given the specific conditions involved. Big difference.
In this case what we have is a new report from the US Preventive Services Task Force, an independent panel of experts on preventive care set up by the Reagan administration to "review the evidence of effectiveness and develop recommendations for clinical preventive services." The PSTF
"recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms."(Incidentally, this backs up a similar conclusion from a study not long ago in Canada.) It's a simple, straightforward message. On looking at the current evidence, the panel found that the benefits of routine mammograms for low-risk women do not outweigh the associated risks.
The second factor making a huge mess of this is that a small proportion of people in this country are convinced that health-care reform is about rationing, killing off Republicans early and making lots of Democrats, and so they jumped in with both feet on the idea that this is a a nefarious scheme to deprive women of their necessary cancer tests. (Like they ever gave a rat's behind before about preventive services for women.) They came out screaming bloody murder (again) over nothing, and this is where we are.
In a way I wish it were a little more like the screamers fear. The profit motive in US health care leads to huge amounts of overprescription, overtesting, unnecessary procedures and other highly profitable waste. I think it would be reasonable to infer that profitmaking insurance companies will look for a way to use this to deny reasonable coverage. This has nothing to do with the public plan, which of course does not yet exist.
But it just isn't that important. It's another data point in the continuing refinement of our understanding that science pursues, no more, no less, and if more experts agree, a consensus may emerge to stop pushing women to have these tests because they're not necessary.
The editor basically gets it right in describing how to respond, but his tut-tutting the experts for unclear communication is ridiculous. The media have messed up the message, not them.