Why are mammograms so popular first one must

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frequencies, rather than conditional probabilities. Why are mammograms so popular? First, one must recognize that there is some benefit, which partly accounts for it. However, the actual costs and benefits of mammography are poorly understood by the public, and even by many physicians. Some of this confusion is intentional: self-interested groups tout irrelevant and misleading numbers, such as the 1 in 9 figure, and withhold information less favorable to mammography, such as the large number of people who undergo unnecessary operations as a
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5 ISBN 0-7432-0556-1 result of false positives. Some feminist groups have made support of mammography a political issue, so that anyone raising questions about it is likely to be accused of prejudice against women. Fear of litigation also plays a role. Physicians aren’t sued by women who undergo needless surgery and are relieved to discover they did not have cancer; they are more likely to be sued by women who discover they have breast cancer and were never screened. Also, one should not ignore self-interested motives. Mammography screening is a big business, and quite profitable to the physicians engaged in it. Since screening is not without benefit to patients, and is profitable for health care providers, most physicians feel comfortable recommending it. Why those physicians who do understand the costs and benefits fail to discuss this information with their patients is another issue. The primary reason seems to be that physicians perceive that their patients want reassurance delivered with an air of certainty, rather than a discussion of the messy facts of the matter. For most of the information in this handout, I have drawn on Calculated Risks . 5 This book explores this and other examples drawn primarily from law and medicine. It would be worthwhile reading if you were considering a career as a criminal lawyer or as a practicing physician.
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