Screening for Cancer Questioned

BHN thinks this it is huge that the American Cancer Society finally admitted that cancer screening sometimes leads to overdiagnosis.

Or did they? This blog item from the Associations of Health Care Journalists notes that ACS backpedaled a day after the NYTimes reported on the society’s change of heart. Check out their links too.  

(Times writer Gina) Kolata’s story was published on Tuesday. On Wednesday, the ACS released a statement from Brawley in which he says the organization stands by its screening recommendations.

Here’s why the mantra  of early detection is a problem. We’ve gotten better at finding cancer but we are not very good at sorting the nasty ones out from the tumors that will never grow. If you have a raging tumor, it doesn’t seem to matter when you find it. And, yes, some malignant tumors –possibly quite a few — never grow.  The concept of early detection was a very successful health campaign. Too bad, in many cases, it was wrong.

Gary Schwitzer of  University of Minnesota School of Journalism believes in evidence-based reporting.  He’s been following the follow-ups on this story and isn’t happy.

New media writer Jeff Jarvis, recently diagnosed and treated for prostate cancer, is writing about screening again: “I say, thank god science for screening.”

 He’s entitled to his opinion. He is not entitled to his own personal version of the facts. He writes: “There is a growing rumble about curtailing screening.”

 No. That is simply wrong. There is no move for “curtailing” screening. There are many, however, who are calling for better and more balanced presentation of the potential harms – not just the potential benefits – of such screening.

The debate over mammography and prostate cancer screening has been around for a while. According to the National Women’s Health Networkfifteen years after the debate about the value of screening mammography first flared up, too many women (and clinicians) still don’t know it’s more complicated than the “early detection is your best prevention” slogan.

The stories of note from the NYTimes. 

 Benefits and Risks of Cancer Screening Are Not Always Clear, Experts Say

Most people believe that finding cancer early is a certain way to save lives. But the reality of cancer screening is far more complicated.

Studies suggest that some patients are enduring aggressive treatments for cancers that could have gone undetected for a lifetime without hurting them. At the same time, some cancers found through screening and treated in the earliest stages still end up being deadly.

As a result, the chief medical officer for the American Cancer Society now says that the benefits of early detection are often overstated. The cancer society says it will continue to revise its public messages about cancer screening as new information becomes available.

And, Gina Kolata’s 10/21 story

The American Cancer Society, which has long been a staunch defender of most cancer screening, is now saying that the benefits of detecting many cancers, especially breast and prostate, have been overstated.

It is quietly working on a message, to put on its Web site early next year, to emphasize that screening for breast and prostate cancer and certain other cancers can come with a real risk of overtreating many small cancers while missing cancers that are deadly.

“We don’t want people to panic,” said Dr. Otis Brawley, chief medical officer of the cancer society. “But I’m admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated.”

As far as mammography goes, Breast Cancer Action has been all over this. In honor of Breast Cancer Awareness month, check out their “Think Before You Pink” campaign while you’re at it.

3 Responses to “Screening for Cancer Questioned”

  1. More on mammography for women under 50 « Boston Health News Says:

    [...] November 17, 2009 — by Tinker Ready Now comes another reversal in the mammography debate. (See ACS flap.) On Monday, a U.S. government agency backed away from a more aggressive approach and concluded [...]

  2. BCAction Says:

    What the Cluck? Tell KFC and Susan G. Komen for the Cure to stop pinkwashing!
    With their “Buckets for the Cure” campaign, KFC and Susan G. Komen for the Cure are telling us to buy buckets of unhealthy food to cure a disease that kills women. When a company purports to care about breast cancer by promoting a pink ribboned product, but manufactures products that are linked to the disease, we call that pinkwashing. Make no mistake–every pink bucket purchase will do more to benefit KFC’s bottom line than it will to cure breast cancer. Join us in telling KFC and Susan G. Komen for the Cure to rethink this pinkwashing partnership.

    Breast Cancer Action
    bcaction.org


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