Mammogram suggestion not a blanket statement

The question about having or not having an annual breast cancer screening exam at age 40 has two answers - one that is personal and one that is based on population data. What is involved is risk assessment. What is best for the individual is not necessarily the same as what is best for the general welfare, i.e., the greatest good for the greatest number.

Each woman can and should make her own risk assessment based on personal circumstances and her tolerance for risk. However, from a public health perspective, the assessment of risk is determined by comparing the number of people who benefit compared to the number who are harmed and receive no benefit.

Resources are limited and need to be allocated where the greatest good is achieved. So why is there a debate about public health guidelines from a panel of experts who considered the general welfare? The panel did not recommend that women not get a breast exam starting at age 40!

With such poor communication, I worry about how any public policy discussions are to be conducted in an informed, rational and intelligent manner. That is the lesson I take from the constant banter about breast cancer screening.

Don Van Hulzen

Iowa City