Decades of evidence reveal a complicated relationship between mammograms and mortality. Mammograms may detect deadly cancers early, but they may also lead to the diagnosis and potentially fatal treatment of cancers that would never progress to cause symptoms. I provide a brief history of the evidence on mammograms and mortality, focusing on evidence from clinical trials, and I discuss how this evidence informs mammography guidelines. I then explore the evolution of all-cause mortality relative to breast cancer mortality within an influential clinical trial. I conclude with some responses to the evolving evidence.

中文翻译：

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乳房X光检查与死亡率：证据如何演变？


数十年的证据揭示了乳房X光检查与死亡率之间的复杂关系。乳房X光检查可以及早发现致命的癌症，但它们也可能导致对永远不会发展到引起症状的癌症的诊断和可能致命的治疗。我简要介绍了有关乳房 X 光检查和死亡率的证据，重点关注临床试验的证据，并讨论了这些证据如何为乳房 X 光检查指南提供信息。然后，我在一项有影响力的临床试验中探讨了全因死亡率相对于乳腺癌死亡率的演变。最后我对不断变化的证据做出一些回应。