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LJR's avatar

The older I get (early 70s) the more wary I am of all these tests--especially mammo-- for exactly this reason. Yet one is led to believe that avoiding them is un-American, incredibly risky, and will piss your doctors off such that the doctor-patient relationship is seriously undermined. I'm always looking for doctors that do not "go by the book" as one once told me. Who are open to being flexible about association-mandated testing and pharmaceutical therapies. But I understand that doctors are evaluated on how many of their patients conform to these norms, they are overwhelmed and worried about being sued for missing something, and just want to get through the day without having to have a big discussion about the DEXA or the mammo. It's really hard to decide what to do--or not do. I've been putting off the mammo and screening pelvic ultrasound for the last year or so, having been lucky enough to never need further testing so far over my many years of these tests. Most people think I'm nuts: What? Just get your mammo!

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Art Steinmetz's avatar

I had a kidney "incidentaloma" in 2009. Complications from the surgery to remove it were life-threatening. Only afterward did I read Dr. H. Gilbert Welch's "Overdiagnosed" which makes the same points you are. Between 1975 and 2005 yearly kidney cancer diagnoses went from 7000 to 13,000 per 100k. Presumably all those diagnoses led to an intervention. Deaths went from roughly 4000 to....4000. So we can conclude NONE of those interventions, on average, led to saving any lives.

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