I don’t know what the actual causal story is here, but it’s at any rate not obviously right that if doctors were good at it then there’d be no reason to increase the age, for a few reasons.
Changing the age doesn’t say anything about who’s how good at what, it says that something has changed.
What’s changed could be that doctors have got worse at breast cancer diagnosis, or that we’ve suddenly discovered that they’re bad. But it could also be, for instance:
That patients have become more anxious and therefore (1) more harmed directly by a false-positive result and (2) more likely to push their doctors for further procedures that would in expectation be bad for them.
That we’ve got better or worse, or discovered we’re better or worse than we thought, at treating certain kinds of cancers at certain stages, in a way that changes the cost/benefit analysis around finding things earlier.
E.g., I’ve heard it said (but I don’t remember by whom and it might be wrong, so this is not health advice) that the benefits of catching cancers early are smaller than they used to be thought to be, because actually the reason why earlier-caught cancers kill you less is that ones you catch when they’re smaller are more likely to be slower-growing ones that were less likely to kill you whenever you caught them; if that’s true and a recent discovery then it would suggest reducing the amount of screening you do.
That previous protocols were designed without sufficient attention to the downsides of testing.
You had a situation where the amount of people who died from cancer were roughly the same in the US and Europe.
At the same time the US started diagnosis earlier and had a higher rate of curing people who are diagnosed with cancer. This does suggest that women got diagnosed in the US with cancer while they wouldn’t have been in Europe with lower testing rates but where whether or not they are treated had in the end little effect on mortality due to breast cancer.
If someone is good at making treatment decisions then he should get better outcomes if he gets more testing data. The fact that this didn’t seem to happen suggests a problem with the decision making of the cancer doctors.
It’s not definite but at the same time I don’t see evidence that the doctors are actually good at making decisions.
I don’t know what the actual causal story is here, but it’s at any rate not obviously right that if doctors were good at it then there’d be no reason to increase the age, for a few reasons.
Changing the age doesn’t say anything about who’s how good at what, it says that something has changed.
What’s changed could be that doctors have got worse at breast cancer diagnosis, or that we’ve suddenly discovered that they’re bad. But it could also be, for instance:
That patients have become more anxious and therefore (1) more harmed directly by a false-positive result and (2) more likely to push their doctors for further procedures that would in expectation be bad for them.
That we’ve got better or worse, or discovered we’re better or worse than we thought, at treating certain kinds of cancers at certain stages, in a way that changes the cost/benefit analysis around finding things earlier.
E.g., I’ve heard it said (but I don’t remember by whom and it might be wrong, so this is not health advice) that the benefits of catching cancers early are smaller than they used to be thought to be, because actually the reason why earlier-caught cancers kill you less is that ones you catch when they’re smaller are more likely to be slower-growing ones that were less likely to kill you whenever you caught them; if that’s true and a recent discovery then it would suggest reducing the amount of screening you do.
That previous protocols were designed without sufficient attention to the downsides of testing.
You had a situation where the amount of people who died from cancer were roughly the same in the US and Europe.
At the same time the US started diagnosis earlier and had a higher rate of curing people who are diagnosed with cancer. This does suggest that women got diagnosed in the US with cancer while they wouldn’t have been in Europe with lower testing rates but where whether or not they are treated had in the end little effect on mortality due to breast cancer.
If someone is good at making treatment decisions then he should get better outcomes if he gets more testing data. The fact that this didn’t seem to happen suggests a problem with the decision making of the cancer doctors.
It’s not definite but at the same time I don’t see evidence that the doctors are actually good at making decisions.