Why cancer screening isn’t all it’s cracked up to be - by Prof Baum
Well worth a read is Prof Michael Baum’s new essay “Why I am still a screening sceptic”, now up on the Spiked website.
Highlights:
‘The largest threat posed by American medicine is that more and more of us are being drawn into the system not because of an epidemic of disease, but because of an epidemic of diagnoses. The real problem with the epidemic of diagnoses is that it leads to an epidemic of treatments. Not all treatments have important benefits, but almost all can have harms.’ (Actually a quote from other writers: “What’s Making Us Sick Is an Epidemic of Diagnoses”, H GIlbert Welch, Lisa Schwartz and Steven Woloshin, New York Times, January 2, 2007).
“More recently, last weekend The Sunday Times reported that more and more women are angry about having had needless breast cancer operations, after research showed that ‘10 patients will be treated unnecessarily for every life saved’. The paper reported my view that, instead of breast-screening the whole female population over the age of 50 every three years, women should be tested ‘according to their level of risk’ - an argument I will expand on in this essay (3).”
“Although it seems counterintuitive, a growing body of informed opinion is moving in the direction of exposing early detection of cancer as just that: possibly a ‘bad thing’.”
“As a result, the overall mastectomy rate rises after any country implements screening in contrast to the message in the NHSBSP leaflet - ‘Breast Cancer: The Facts’ (10) - which implies that screening saves breasts. It doesn’t.”
“I want to argue that some of these earliest stages of ‘cancer’, if left unperturbed, would not progress to a disease with lethal potential.”
“…you would need to screen 1,400 men for 10 years to save one prostate cancer death at the expense of over-diagnosing 48 cases of cancer that would be treated with radical surgery that frequently leads to impotence and incontinence and on rare occasions death from the complications of surgery.”
