Their "benefit-risk characterization theater" images vividly show the odds, based on solid research. There's a sold-out house of 1,000 playgoers or concertgoers, all getting a particular kind of exam, screen or pill.
Then the curtain falls. Everybody helped by the procedure or prescription gets up and leaves. Often it's only a few people. Sometimes very few. Or nobody.
For breast exams, only one woman in the thousand-person theater receiving mammograms over a lifetime is saved from dying by detecting a cancer before it spreads, according to Lazris' and Rifkin's summary of the research.
At the same time, hundreds of women in that audience will receive test results suggesting they have cancer when they don't — "false positives." Sixty-four get biopsies, which generally involve cells withdrawn through a needle, for nonthreatening lumps.
Ten receive unnecessary treatment including radiation and surgery for lumps that never would have caused a problem.