We can complain about the cost of American health care but that is the price for doctors caring too much. While in Holland doctors can just unilaterally make the decision to let a patient die, in the United States doctors will continue to recommend tests even when recommendations are that they should be done half as often.

In 2009, the U.S. Preventive Services Task Force (USPSTF) recommended that women  be screened biennially beginning at 50 years old and continuing through age 74 but the vast majority of surgeons continue to recommend that women 40 years old or older with an average risk for breast cancer be screened annually.

88% of breast surgeons and 82% of general surgeons continue to recommend annual mammography for women with an average risk of developing breast cancer - and for themselves, 93% reported that they began or would begin annual screenings at age 40.

"We found that the majority of surveyed breast surgeons advocate and personally follow the screening mammography recommendations of the American Cancer Society, the American College of Radiology, and the Society of Breast Imaging, instead of those of the USPSTF," said coauthor Vilert Loving, director of breast imaging at the Banner MD Anderson Cancer Center. Coauthors Jiyon Lee (NYU Cancer Institute) and Elaine Tanaka (VA San Diego Healthcare System and UC San Diego School of Medicine) added, "As we anticipate the USPSTF's impending guidelines this year, the public should know that the physicians who diagnose and treat women with breast cancer still believe in annual mammography starting at age 40 for average-risk women."

The study was presented at the ARRS 2015 Annual Meeting in Toronto.