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For decades, public health, the government, and the news media have preached the mantra of early detection, and spent millions of dollars to spread the word. Now, the hypothesis that increased screening at all costs, is vital to health and longevity is being questioned. Researchers and bioethicists are beginning to question the outcome vs. costs, and potential for harm vs. potential benefit. The United States Preventive Services Task Force now recommends that most women delay the start of routine mammograms until they are 50, rather than 40. It also recommended that women receive the test every two years rather than annually, and that physicians not train women to perform breast self-examination. They also recommend delaying Pap smears until age 21- regardless of sexual history, and then to be performed every three years from ages 21-65 (with adjustments for certain clinical considerations), asserting that mammograms and Pap smears can cause more harm than good for women of certain ages.
As public health professionals, we realize the immense good that comes from health screenings, but we still have to weigh out the pros and cons, as well as potential ethical issues, which may become increasingly more salient with increased technological advances (an example would be genetic testing to assess disease risk and treatment options leading to the potential for rationing health care).
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