Cancer Screening

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Cancer Screening

Posted 10/31/2011

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I have written before about breast cancer screening--specifically, the best use of mammograms (annual) and breast MRIs (also annual for women at very high risk--usually means women who carry a genetic mutation or have had more than one breast cancer). This is an essay from the New York Times which is broader; it considers the value of screening for several kinds of cancer. This is a tricky and controversial topic as common sense would often suggest that screening/earlier detection is a plus. The reality is that it often does not matter, in the outcome, whether a cancer is found a little earlier from some kind of test--and that sometimes the interventions/treatments are damaging. This is especially true for prostate cancer, and the reasons are discussed below. Here is the introduction and a link:

Considering When It Might Be Best Not to Know About Cancer

By GINA KOLATA After decades in which cancer screening was promoted as an unmitigated good, as the best — perhaps only — way for people to protect themselves from the ravages of a frightening disease, a pronounced shift is under way.

Now expert groups are proposing less screening for prostate, breast and cervical cancer and have emphasized that screening comes with harms as well as benefits.

Two years ago, the influential United States Preventive Services Task Force, which evaluates evidence and publishes screening guidelines, said that women in their 40s do not appear to benefit from mammograms and that women ages 50 to 74 should consider having them every two years instead of every year.

This year the group said the widely used P.S.A. screening test for prostate cancer does not save lives and causes enormous harm. It also concluded that most women should have Pap tests for cervical cancer every three years instead of every year.