Americans would do well to take a deep breath and step back from the recent uproar over mammograms. The furor began last week, when the U.S. Preventive Services Task Force unveiled recommendations in the making for several years. It urged that screening for breast cancer be scaled back, especially for women in their 40s. The panel says that for each 40-something life saved, more than 1,900 women must be screened for 10 years. In the process, hundreds of false positives are recorded, leading to unnecessary anxiety, biopsies and treatments. The task force recommends dropping annual screening for women in their 40s, and testing women 50 and older just every two years.

The alarmed response demonstrates just how invested Americans have become in the idea of early cancer detection. But breast cancer, which provokes great fear, is far from straightforward. In younger women, dense tissue can make it harder to detect problems with mammograms. Some show evidence of pre-cancerous conditions that will never need treatment. At this point though, physicians cannot always be sure which tumors will cause trouble.

Compounding the difficulty are the limitations of mammography itself. Newer digital equipment may improve the test’s accuracy. But it could also generate more false positives. The task force has been criticized for relying on older data, and hence older equipment, but it could not find proof that newer technologies produce better data. And there are health risks associated with too frequently undergoing procedures that involve radiation.

The latest recommendations are not binding, and in fact they are quite similar to the stand the task force took in the 1990s. Those, obviously, did not change policy. Every state but Utah requires insurers to cover annual mammograms beginning at age 40. The task force said women with special risk factors should continue with routine screening. The upshot is that little has changed: Women should still decide on testing in consultation with their doctors. The task force recommendations have introduced more doubt, but doubt matches the state of the science.

Shortly after the mammogram recommendations came out, the American College of Obstetricians and Gynecologists unveiled new guidelines urging less cervical-cancer screening. Some foes of health-care reform saw not coincidence but conspiracy: Surely all these reduced-screening guidelines are just a taste of the rationing the country is in for if a bill passes — as opposed to the income-and-private-insurance-based rationing we have now. But the case for fewer cervical screenings is even stronger than the case for fewer mammograms. An American Cancer Society official says that every year, 15 million Pap tests are performed on women lacking a cervix because of a hysterectomy.

If anything, the current health bills would expand mammogram use, by making it available to more women. Most doctors (who have little financial incentive to back fewer tests!) are unlikely to make drastic changes; Health and Human Services Secretary Kathleen Sebelius has insisted that the task-force recommendations will not determine policy.

Americans should not let such reports scare them away from health-care reform. But they should welcome a discussion, over the years ahead, about how much care we actually need, and what it costs. It often seems that Americans want all the health procedures they can get –– when somebody else is paying for it –– even if they don’t need it. The incentives for wasteful, medically ineffective or even injurious spending on procedures are immense, and must be addressed.