Aims and Value of Screening: Is Perceived Safety a Value for Which to Pay?

In Chapter 4 on evidence-based medicine and ethics, we presented the example of breast cancer screening and reported that more than 1000 women must be screened with mammography to prevent only one death from breast cancer. In addition, screening generates several false-positive and some false-negative results. Furthermore, 13 women would be diagnosed with breast cancer and would probably be treated. However, these 13 women would not benefit from the treatment because they have a “pseudodisease” (see Chapter 11). Pseudodisease is a result of breast screening in that it cannot be diagnosed in individual patients but only concluded statistically by comparing populations of women who have or have not been screened.