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Cancer screening

Cancer Screening is Essentially Useless; Experts Finally Begin Questioning Sanity of "Routine Screening"

Tuesday, November 17, 2009 by: David Gutierrez, staff writer
Tags: cancer screening, mammograms, health news

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(NaturalNews) Cancer experts are expressing increasing concern over the explosion of campaigns urging people to get regularly screened for a wide variety of cancers, warning that such programs may do more harm than good.

"It is a real problem," said Otis W. Brawley of the American Cancer Society. "They are doing things that might actually harm the people they want to help."

Brawley made his comments about supporters of Rep. Debbie Wasserman Shultz's bill that would mandate an education program to promote breast cancer self-screening among young women. But the comments could just as easily apply to supporters of the American Urological Association's ad campaign urging prostate cancer screening, or the Light of Life Foundation's ads promoting screening for thyroid cancer.

There are now campaigns to promote regular screening for nearly every variety of cancer, based on the widespread popular belief that early detection of cancer is important in saving lives. Yet experts note that for the vast majority of cancers, there is little support for this belief.

In the absence of specific risk factors like a history of smoking or family history of a certain kind of cancer or symptoms like a lump there is no evidence that routine cancer screening reduces death rates. There are only three exceptions to this general rule, said the United States Preventive Services Task Force, a panel of medical experts commissioned by Congress. Women should get regular pap smears starting at age 21 and mammograms starting at age 40, while all people should be screened for colon cancer starting at age 50. Of these three, the evidence for the usefulness of breast cancer screening is the weakest.

Critics of cancer awareness campaigns note that such campaigns can make people think that the risk of dying from cancer is actually much higher than it really is. For example, contrary to what the current ad campaign might suggest, only 1600 people die from thyroid cancer each year in the United States. An incorrect assessment of risk might lead people to perform unnecessary screenings that can actually be harmful.

"There are five things that can happen as a result of screening tests, and four of them are bad," said task force Chairperson Ned Calonge. The only positive result, he said, is identifying a life-threatening cancer early enough for treatment to be helpful. Harmful results include detecting an aggressive cancer that will not respond to treatment no matter how early it is detected, detecting a stable or slow-growing cancer that does not require treatment, falsely detecting cancer where there is none, or failing to detect a real cancer and thus giving patients a false sense of security as symptoms begin to develop.

False positives lead to unnecessary, painful and traumatic biopsies and other procedures, even when they do not lead to treatment for a cancer that does not exist. Even when cancers are real, treatment is not necessarily helpful. Yet because few tests exist to determine how aggressive a cancer is or how it will respond to treatment, most patients are given the full barrage of therapies such as radiation, chemo and surgery. In many cases, these treatments are costly and carry debilitating side effects. Treatment for prostate cancer, for example, can often lead to impotence and incontinence. In most cases the disease grows too slowly to be dangerous, however.

On top of the physical and emotional costs, cancer screening is costly. U.S. women spend $4 billion on mammograms every year, leading to between $1.4 and $7 billion worth of unnecessary biopsies and other surgeries on healthy breasts each year.

Most experts recommend that people talk with their physicians to gain an understanding of what cancer tests might be helpful for them as individuals. In contrast, mass cancer screening is like a lottery, said Barnett S. Kramer of the National Institutes of Health.

"In exchange for those few who win the lottery," he said, "there are many, many others who have to pay the price in human costs."

Sources for this story include: www.nytimes.com.

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