To scan or not to scan

I am puzzled by the media critic Howard Kurtz's reaction to the federal panel's controversial recommendation on mammograms, which starts out sounding like reportage then turns into, basically, a rant:

I have never seen a government health-care finding get shouted down as loudly or vociferously as this strange recommendation on mammograms.

Almost in unison, journalists, politicians and ultimately White House officials reacted to the advice that women in their 40s no longer seek breast cancer screening with this question: What were they thinking? (And I'm cleaning it up.)

I understand that there's a serious scientific debate over the positive and negative aspects of mammography, and the don't-worry-be-happy-till-you're-50 finding of the U.S. Preventive Services Task Force grows out of such research. But that brings us to the essential problem with such studies.

In the broad sphere of health care, it may well be that some tests produce minimal returns -- and, worse, might lead to unnecessary surgery, as the task force noted.

But what if the patient involved is your mother, your sister, your daughter?

Well. I don't want my mother, sister, or daughter to get breast cancer, but nor do I want them to have unnecessary, life-endangering surgery. If the data show that mammograms are causing false alarms, which come with their own grave health risks, then it's conceivable that more mammograms lead to worse health outcomes.

I understand that this panel has just handed opponents of health reform an opportunity: they can cry "rationing"! But the recommendation has to do with risk analysis. Perhaps the recommendation is wrong. Some experts think it is. But the unwillingness of commentators like Kurtz to grasp its basic logic is disconcerting.

Why set the current guidelines at 40 years, after all, and not 30, 25, or 16? If it were your mother, sister, or daughter, wouldn't you want her scanned as much as possible, as early as possible? No, you would not.