Abstract for: A Dynamic Model for Breast Cancer Screening: Misperceptions and Feedback in Screening Mammography Debate
In this study we develop a feedback rich theory to explain the dynamic nature of the screening problem within the US context. Our model is tightly grounded in evidence base, parameterized for the US data and replicates the basic dynamics concerning breast cancer, including the diffusion dynamics for mammogram screening and the noncompliance with recommendations against screening. We demonstrate how a medical decision making-process is distorted by misperception of risks, over-awareness, and by other special features which further distort the quality of the discussion, like single-issue advocacy groups and gender politics. The entire system is shown to dynamically interact with available facts to cause a self-reinforcing over-awareness and over-screening trend for breast cancer in the US, which leads to over-diagnosis and over-treatment, i.e. the over-use of health services. The dominant feedbacks are shown to drive the system towards a balance that is not consistent with the optima.