Is There Too Much Screening For Cancer?
There’s a simply fantastic Viewpoint in this week’s JAMA that addresses that issue. The basic premise is that over the last 30 years there’s been a real emphasis on “awareness” of and screening for cancer. The idea has always been that this will lead to earlier detection and fewer deaths from cancer. I have argued here repeatedly that this has often led to a much larger increase in diagnosis (and therefore treatment) relative to any declines in mortality.
This is mainly because not all cancer is the same. Some of it might never progress to becoming dangerous. Screening, therefore, picks up cancer that really didn’t need detection. This leads to treatment, and all its negative consequences, without any actual gains in mortality.
Entire post by Aaron Carroll worth reading.
Doesn’t the diagnosis identify whether it is malignant cancer or benign cancer?
That’s exactly what I was thinking…
How could they be treating too quickly when they identify both.
I would agree with Dr. Goodman, but I do think that it does more good than harm, because some people do have malignant cancer and they have no idea, and it is better for them to try and address it early than randomly die, only for their family to find out later.
“Screening, therefore, picks up cancer that really didn’t need detection. This leads to treatment, and all its negative consequences, without any actual gains in mortality.”
Does it always lead to treatment?
(Not to be overly pessimistic in mankind’s goodness), but Doctors do have an incentive to over-diagnose, so that they make more money off of expensive cancer treatments.
Wouldn’t better interpretation of the results lead to less “negative consequences, without any actual gains in mortality.”
Yeah, isn’t more information a good thing. Acts on that information should be considered as separate.
Probably, that’s why the subtitle is “An Opportunity for Improvement”
Let the market decide if there is an excess of cancer screening out there.
“‘In both groups, the depression values fell significantly,’ says Professor Andreas Maercker, summing up the results of the study.”
I’m curious as to how they measure depression. That seems like a very important factor.
Americans are especially scared of cancer — such that we’re willing to endure all manner off screenings in hope of catching it before it kills us.