Benefits and damages of Screening. Overdiagnosis and anticipatory medicine
DOI:
https://doi.org/10.19230/jonnpr.3299Abstract
Treatment of breast cancer has changed markedly since the publication of papers recommending screening programs for early diagnosis. Posterior reevaluations demonstrated mistakes; advances in oncological therapy and better knowledge of the problem have demonstrated the doubtful efficacy of these procedures which, on the other hand have also side effects with risk of overdiagnosis and overtreatment. Misinformation confuses patients. This procedure has been recommended by many institutions without explaining possible important risks. It is very easy to promote mammograms if the majority feel that it reduces risk of breast cancer and saves many lives. Unfortunately this is not the case. At present there are many people against screening who are recommending explicit and precise explanations of the procedure as well as of the importance of physical examination. Women must discuss with their physicians their own risk, possible benefits and eventual risks and damages of mammograms and they must take informed decision about screening. Women should be classified in those with potential benefits of mammograms and those with more risks than benefits. A program which does not offer clearly more benefits than risks cannot be implemented by Public Heath institutions. Complete and impartial information, adequate attention and prevention of overdiagnosis and overtreatment would be the best option.
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