By Lenore Skenazy: It does not come as any kind of surprise that right on the heels of a federal advisory panel's recommending that most women wait to start screening for breast cancer till age 50, lots of women — and their doctors — are saying: "Forget what the experts say. Bring on the mammograms!"
It does not come as any kind of surprise that right on the heels of a federal advisory panel's recommending that most women wait to start screening for breast cancer till age 50, lots of women — and their doctors — are saying: "Forget what the experts say. Bring on the mammograms!"
That's the American mindset. We want our tests even if we don't need 'em. But me, I'm very happy about the new recommendations — and not just because false positives led me to double breast surgery, complete with general anesthesia, a couple of years ago. (All negative — I'm fine.)
The advisory panel found that the earlier advice we all had been hit over the head with — that women need to start getting yearly mammograms at age 40 — was unwarranted and even counterproductive. The annual tissue squishing was saving one life for about every 20,000 tests performed over the course of a decade. I know that one life is never insignificant. Never. But neither are the downsides of excess testing. These perils, said the panel, include a lot of false positives and/or the detection of slow-growing cancers that would have been better off left untreated — but treated they were, sometimes creating great misery. (And let's not even get into the idea of whether or not yearly radiation is a good idea. Or what health initiatives we could fund if we freed up the money from millions of mammograms.)
"We have to say what we see based on the science and the data," said Dr. Diana Petitti, vice chairwoman of the advisory task force. She knows that her findings fly straight in the face of not only previous advice but also the American mentality, which believes that any safety precaution in any sphere of life is worth it, no matter what the cost, in dollars, in trade-offs, in humanity.
It is hard to have a conversation about anything that has to do with risk in America, because any risk is seen as too large. That's why mammograms turn out to be the perfect metaphor for our entire outlook: Even when we are being told the benefits are low and don't outweigh the costs, we still want them, just in case.
It is this "just in case" obsession that is making our country so terrified of what we used to call "life." Go to the playground of your youth and you probably will find it now devoid of seesaws. Why? Because someone could get hurt on them. So despite the joy they bring to millions, the seesaws have been removed, just in case. Same with tall slides. Same with merry-go-rounds. We've performed pre-emptive surgery on our playgrounds.
Manufacturers understanding how lucrative the zero-risk mentality is have come up with "safety" devices — such as antimicrobial scissors, which are great if the only thing you plan to touch all day is a pair of scissors. Otherwise, they're ludicrous — but the stores are full of them. Down the aisle, there are helmets for kids learning to toddle, on the very, very off chance their skulls don't do the brain-protecting job they've done for the past 300,000 years of evolution. Someone is buying these devices, just in case.
When Philip Howard, author of "Life Without Lawyers," was going in for surgery, he had to take a series of preoperative tests. Turns out, he'd taken those very same tests just a month or so earlier and asked to submit those results instead. He even offered to sign a waiver absolving the hospital of any problems that might have arisen from the lack of up-to-the-second tests.
No dice. Because of our litigious mindset and the irrefutable truth that nothing is ever 100 percent safe, he had to retake the tests. Never mind the waste in money and time — his and the hospital's.
Call it covering our collective behind. Call it worst-case-scenario thinking. Call it overkill. We've gotten used to taking all possible precautions, even when they don't make sense.
You don't need a mammogram to see what beats inside the breast of this country: an unreasonable belief that we can eliminate all risk and an unwillingness to consider what we give up in the process.
Lenore Skenazy is the author of"Free-Range Kids: Giving Our Children the Freedom We Had Without Going Nuts with Worry." E-mail her at firstname.lastname@example.org.