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The Truth on Cancer Screening

This week is Cancer Screen Week. It’s a one-sided campaign sponsored by industry and the American Cancer Society that urges people to get screened.

The truth is that the scientific evidence for cancer screening is not convincing. What’s more, screening comes with potential harms.

I know; it’s counter-intuitive, but it’s what the evidence says.

Benjamin Maser is a medical doctor (pathologist) and writer at Yale.

Check out our editorial on WBUR> Does Cancer Screening Save More Lives Overall? Not Necessarily

By the way, you may be thinking: what does a pathologist and a cardiologist know about cancer screening?

My answer is that one need not be a cancer specialist to interpret basic studies. The controlled trials compare a group of people who got screened vs those who do not. These studies, which we cited in the editorial, show that overall mortality is essentially the same in both groups.

That’s not complicated. Nor is understanding the notion of over-diagnosis and over-treatment.

In the article, we favor honesty, balance and informed decisions–not fear and bullying.


2 replies on “The Truth on Cancer Screening”

Mammograms for women with dense breast tissue detect only about half of cancers. More premenopausal women have dense breast tissue than not. Dense breast tissue is much more likely to be cancerous. Mammograms involve some radiation and a slight risk of causing a cancer. And yet women with dense breast tissue are routinely given mammograms and these women are given “good news” when in fact the news may be bad. Ultrasounds detect 97% of breast cancers. They are not used as the first option. My wife had 11 years of “good news” only to find out after requesting an ultrasound that she had breast cancer that spread to the sentinel nodes. It wasn’t the aggressive type of cancer so she probably had the cancer for years that could have been caught before it spread. Most women aren’t aware of the impact of dense breast tissue regarding testing and risk of cancer. Most aren’t even told they have dense breast tissue. Many states have been passing laws about this.

The fundamental problem: our health care system is designed primarily to make money, not deliver health care. Expensive tests and treatments get pushed, guidelines for BP and lipids get pushed lower and lower for very modest benefit but big expense. Every study that is stopped early so the company can immediately start selling the drug (eg Entresto) is, in my opinion, a corrupt study. If a health care system’s first job is health care, we are way off base.

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