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 线照片和死亡率：证据是如何演变的？

数十年的证据揭示了乳房 X 线照片和死亡率之间的复杂关系。乳房 X 光检查可能会及早发现致命的癌症，但它们也可能导致诊断和潜在的致命治疗，这些癌症永远不会发展为引起症状。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，我对不断发展的证据做出了一些回应。