“If there is a test but there’s problems with it, I often go over this with a patient and how to decide if it’s necessary.”
Add mammography to the list of cancer screenings where evidence has challenged “best practices.”
Dr. Sanjay Gupta of CNN reported in EveryDay Health that while early cancer detection can save lives, recent studies raise new doubts about the benefits of screening without considering the risks as well.
“Cancer death rates overall have declined since the early 1990s. One of the reasons for the trend is advances in screening technology that have made it easier to detect cancer at an early stage, when it’s most likely to be curable. But these tests aren’t without controversy. One new study raises serious questions about how effective mammograms are at reducing breast cancer deaths.”
“In a recent study published in The British Medical Journal, the 25-year study compared breast cancer incidence and mortality among nearly 90,000 Canadian women, ages 40-59. Researchers found the death rate to be nearly identical between women who did or did not get regular mammograms. ‘The data suggest that the value of mammography screening should be reassessed,’ the study concluded.”
Some screening tests have an especially high rate of false-positive results. The Susan G. Komen for the Cure foundation estimates the risk of false-positive mammogram results is 61 percent. The National Cancer Institute (NCI) reports that 75 percent of positive results from the prostate-specific antigen (PSA) blood test for prostate cancer turn out to be false-positives. Such false alarms can lead to more tests, treatments, and physical as well as psychological consequences. The article notes:
Mammography isn’t without risk. Factors such as the density of a woman’s breast tissue can produce inaccurate results.
Colonoscopy is still vastly under-utilized compared to mammography. Part of that is because people don’t like to think about their bowels.
Prostate Cancer – The blood test used to diagnose prostate cancer measures PSA protein levels — a high PSA level may indicate cancer, but other conditions can also be to blame. Only about 25 percent of men with an elevated PSA actually have prostate cancer, according to the ACS.
Ovarian cancer is one of the most difficult cancers to detect in its early stages. Many of its symptoms — such as bloating, pelvic pain, and loss of appetite — can be mistaken for digestive problems or other conditions. Once the cancer has spread from the ovaries to the pelvis and abdomen, the prognosis for treatment is very poor.
Ask your primary care physician for advice given the ambiguity over the “evidence.”
Click here to read the full EveryDay Health article, “What You Must Know Now About Cancer Screening”, by Dr. Sanjay Gupta.
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Doctor, Did You Wash Your Hands? ™ provides information to consumers on understanding, managing and navigating health care options.
Jonathan M. Metsch, Dr.P.H., is Clinical Professor, Preventive Medicine, Icahn School of Medicine at Mount Sinai; and Adjunct Professor, Baruch College ( C.U.N.Y.), Rutgers School of Public Health, and Rutgers School of Public Affairs and Administration.
This blog shares general information about understanding and navigating the health care system. For specific medical advice about your own problems, issues and options talk to your personal physician.