The newest contretemps over mammography is yet the latest eruption from a debate that has been simmering for decades, boiling over at regular intervals onto the front pages of newspapers, the floors of Congress, and the laps of expert panels (1). But a closer look at this controversy, which is officially joined here by publication of the rationale for the recommendations of the U.S. Preventive Services Task Force (USPSTF) (2), shows that its focus has shifted in a way that poses a dilemma not only for women and their doctors, but for evidence-based medicine itself.

The debate in the 1990s ...

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