Q. My spouse and I have always kept one another on track for routine mammograms and prostate cancer screening. Should we now stop?

A. The U.S. Preventive Services Task Force recently recommended that women between ages 40 and 49 no longer receive mammograms. They argue that routine screening in this age group results in unjustified costs, and at times false positives leading to unnecessary biopsies and psychological trauma.

Not long ago, the U.S. Preventive Services Task Force also advised that the harm outweighs the risk of testing men over age 75 for prostate cancer. That is because, in most cases, prostate cancer in an older man will probably move rather slowly and not lead to significant problems as the person lives out his natural life. Similarly, the Task Force claims that blood tests for prostate-specific antigen to find prostate cancer in a man 75 or older may too often lead to needless worry and costly, unnecessary treatment.

Cancer survivors protest that they would not have survived had their cancer gone undiagnosed until there was a large, hard, fixed breast mass or in the case of prostate cancer possibly blood in the urine.

The mission of the U.S. Preventive Services Task Force is to optimize public health. Its focus is a healthy herd at reasonable cost and not the optimal health of any one individual. Now, as we move closer to healthcare reform in this country, the public is increasingly suspicious of government moves that may limit needed health-care services in order to free up resources to cover the underserved. In any case, these recommendations should be treated as guidelines only.

My recommendation is that you make decisions regarding cancer screening with your physician, decisions that are right for you and consider your family history, other risk factors and your psychological make-up. Remember, screening tests only qualify as secondary prevention. Primary prevention is the first line of defense against illness and emphasizes diet, lifestyle and healthy spirituality.