Since a government task force came out with revised guidelines for breast-cancer screenings, I've heard it called a precursor to the kind of socialized medicine nobody wants, which is government controlled health-care rationing.

It's true that the new guidelines are more in line with places like Great Britain, where the national health sys-tem covers mammograms every three years for women once they turn 50, but to see it as the start of some kind of rationing system strikes me as premature, at least. The recommendations are just that, and not national policy.

The U.S. Preventive Services Task Force now recommends that women in their 40s not get routine mammo-grams. The reversal sparked a flood of criticism, from organizations like the American Cancer Society and other experts who for years have worked to get women to take the threat of breast cancer seriously and get across the importance of early detection. It was hard enough to get some women to take a test many would rather avoid, and the job just got harder.

The task force, made up of doctors and scientists, based the recommendations on a review of data, weighing the effectiveness of testing against the risks involved. The conclusion was that for women in their 40s the benefits of mammogram screening were outpaced by the number of false alarms, which can lead to considerable anxiety and unnecessary biopsies.

It's important to note a distinction here. The panel did not say that women in their 40s should not get mammograms. It said that the testing should not be routine, and that women in that age group should talk with their doctors, the people in the best position to help them weigh the benefits and risks involved.

This makes a great deal of sense, assuming that your primary care physician can lift his or her head from the mountains of paperwork insurance requires and have enough time to hold such conversations.

There is also concern that insurance coverage will be dropped because of the new recommendations. At this point that doesn't seem likely, particularly if the screening comes from a doctor's referral.

The more complicated the world becomes, the simpler we want it to be. We've all gotten beyond the promise of, say, 1950s science fiction, which predicted that technology would one day give us so much free time we wouldn't know what to do with it. If anything, technology presents us with more complicated decisions, and nowhere is that more true than in the progress of medicine. We can live longer, healthier lives, but it comes at a price, which includes our involvement in own health.

So, yes, the new guidelines may make it more confusing when it comes to deciding what to do, but maybe that's the way it ought to be.

This is the case with some other cancers as well. For prostate cancer, the screening is a digital rectal exam, which I don't want to talk about, and a blood test called the prostate specific antigen test. The PSA, as it's called, was not developed as a screening tool but to monitor already detected cancer. But, as a doctor told me a few years ago, these days everyone wants a screening, and PSA is the closest there is.

Even if it shows you have cancer it doesn't mean you should do something about it. If it's slow growing, and you're old, something else is more likely to lead to your demise. You may feel better off living without the potential complications of treatment, which include impotency and incontinence.

Such uncertainty leads the Centers for Disease Control and Prevention to recommend informed decision mak-ing when it comes to prostate cancer screening and treatment, based on your options and how you, as an individual, feel about them.

That doesn't make it easy, but that's the way it is.