People have stopped going to the doctor and most seem fine

Even in the case of asthma, I think a doctor would hopefully not treat it like cookie cutter Health care. Surely there are standards and best practices, but then there is also the actual practice of medicine.

Standards might suggest 1 year is fine, but he Generally a doctor might want to see young (Kids) and old patients more often than a otherwise healthy adult, perhaps the doctor has reason to belief seasonal allergies/pollen may be effecting patients more in a given year, and (not to give doctors to much credit)again the idea the doctor has concerns with a given patient’s track record of adherence Issues and/or medication related hospitalizations.

That seems exaggerated - the 'unnecessary surgeries' are biopsies, right? Hardly a life-threatening procedure. That sounds hyperbolic too?

This 20-year-old study shows that mammograms are matched by excellent screening programs in Canada. Is that the choice being made today? The screening programs in Canada were discontinued. Is the real choice now between mammograms and nothing? I didn't understand that development at all.

In the last 10 years, there's been a decrease in mortality by 25% or better. That's the good news today. And its all attributed to early detection. Clearly the most important factor in survival.

I think 20-year-old data is not the greatest basis for an informed choice on this subject. E.g. MRIs became common after that study was over. The world has changed, a lot, since then.

It was published in Feburary 2014.

I'm not intentionally trying to sound hyperbolic. Are you? They are literally classified as invasive procedures. It is by definition unnecessary. There are going to be false-positives in these screenings and these false-positives can be harmful. Early detection + cancer = good. Early detection + no cancer = bad. So we must balance these two. I agree detecting cancer early is a good thing, but that's not what I was saying.

What's the deal, do you think there's no false positives, do you think over detection has no harms?

If you want something more recent, here's one published February 2020:

"...A further contributor is overdiagnosis, or the diagnosis of cancer in people who would never have experienced symptoms or harm had the cancer remained undetected and untreated. Overdiagnosis of certain screen‐detected cancers is common including 20–50% of prostate cancer and 11–19% of breast cancer diagnoses.

Cancer can also be overdiagnosed outside screening programs. Overdiagnosis of thyroid cancer is attributable to incidental detection during investigations of unrelated problems; overdiagnosis of renal cancer and melanoma is less well investigated.

Overdiagnosis is important because of the associated iatrogenic harms and costs. Harms include the psychosocial impact of unnecessary cancer diagnoses, such as the increased suicide risk for men after being diagnosed with prostate cancer. Cancer treatments such as surgery, radiotherapy, endocrine therapy, and chemotherapy can cause physical harm, but the risks are considered acceptable if diagnosis is appropriate. When someone is unnecessarily diagnosed with cancer, however, they can only be harmed by treatment, not helped."

...

"Overdiagnosis of breast cancers is largely attributable to the national screening program, that of prostate cancers and melanoma to opportunistic but extensive screening in Australia. Renal cancer overdiagnosis appears to be largely linked with cancers detected as incidental findings during abdominal imaging for an unrelated reason (incidentalomas). Overdiagnosis of thyroid cancer is related to both incidentalomas and to excessive investigation of thyroid function test abnormalities"

https://www.mja.com.au/system/files/issues/212_04/mja250455....