Welcome back to the channel. We're going to be talking about something that I've been meaning to do a deep dive on.

Mammography. Mammographic screening for healthy women. This isn't about women at elevated risk of breast cancer people with hereditary brachma mutations.

This is about average risk women. This is about the new USPSTF guidelines, the United States Preventive Services Task Force.

This is about mammograms preventive.

Do they save lives?

And that's what I'm going to talk to you about today.

I've been studying this for about 10 or 15 years, published a number of papers on this topic.

I'm going to walk you through my papers, other people's papers.

I'm going to build the case for three themes.

One, I don't think it saves lives. If save lives means living longer, there's no strong

evidence that that's the case. We need to replicate the most basic randomized controlled trials

in this space. We need to power those replicatory efforts for overall survival, not just

breast cancer-specific death. Let's get into it. Let's get into it. So what is the purpose of

screening? The purpose of screening,

of course, is to find cancer. The first thing you want to do is you want to find cancer. You

can't have a screening test that doesn't find more cancer than you otherwise would. It would

be ineffective from the get-go. So you've got to find cancer. But that's not the end of the road,

but that's the first step. Well, it turns out some interventions don't got to find cancer. But that's not the end of the road. But that's the first step.

Well, it turns out some interventions don't even find more cancer. For instance, a self-breast

exam. We lack robust, randomized evidence that you even find more cancer. Let me go ahead

and show you the results from the Shanghai study. This is the Shanghai large, randomized control

trial of women in Shanghai instructed to do a self-breast

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