Breast cancer screening in older women: the consumer perspective.
Fear of cancer and weak support from physicians make it difficult to encourage women to have regular mammograms. An effective campaign of broad mammography screening should be aimed at both health professionals and women. Essential to this screening is a public policy that establishes public and private insurance coverage. Barriers, including high cost, must be eliminated. Effective organization can succeed in reaching more older women for screening. Rationing breast cancer screening, at a time when the incidence of breast cancer is increasing, violates fundamental beliefs in equality and justice. Proposals to limit or to expand screening require a defensible and supportable rationale. Health professionals should not decide for patients whether they should have a mammogram and what treatment is best. The physician should counsel and assist the patient or the surrogate to decide on an appropriate plan of care.