If you're an average health-conscious American over 40 years of age, regular cancer screenings are likely to be a part of your healthcare routine. The cancer industry heavily promotes the use of regular mammograms, pap smears, blood tests, colonoscopies and even full-body CT scans as ways to "prevent" cancer fatalities.
Recently, several studies have concluded that the benefits of regular cancer screenings aren't as effective as the cancer industry would like you to believe. Problems with false positives and over-aggressive treatment of pre-cancerous cells that are better off left alone have cast doubt on the whole premise of cancer screening.
The U.S. Preventive Services Task Force recently dropped their long-standing recommendation that women get routine annual mammograms starting at age 40. Instead, it said women should wait until the age of 50 and be screened every other year. They based this recommendation on the evidence that shows that annual mammograms have been ineffective at reducing cancer fatalities, and that they may have serious health consequences that make them more a risk than a benefit.
The statement was met with violent criticism from professional associations and government agencies. Groups like the American College of Radiology, the American Cancer Society joined with politicians to argue that the new guidelines would deprive women of a life-saving test. Some even accused the government of using this study just to cut healthcare costs.
But think for a minute — the organizations and individuals that protested the new guidelines (including the non-profits) all have strong financial interests in the cancer industry. Regular cancer screenings are big business, and drug companies, radiologists and oncologists would stand to see a big drop in their income if cancer screenings were cut back.
Cancer prevention, through diet and lifestyle, is a strategy designed to minimize your risk of ever getting cancer and has been shown to work better than anything else.
Early treatment is a strategy that's used after you've already developed cancer. Every year, millions of people who don't practice any sort of cancer-preventive measures get cancer screenings, and think that they're being responsible for their health. At the same time, they provide a steady and reliable revenue stream for the cancer industry.
1. The Overwhelming Majority of Patients Who Are Screened Receive No Benefit.
That's because, despite all the alarming statistics you hear, most people will not get cancer. Let's look at breast cancer as an example.
According to government statistics, the risk of a woman between the ages of 55 and 70 dying from breast cancer in the next 10 years is 9 in 1,000.
Statistics show that undergoing regular breast cancer screening starting at age 40 only decreases a woman's risk of dying from cancer by 0.05 percent — that's 1 in 2000. It increases to 0.2 percent for women in their 50's — that's 1 in 500. This might be considered worthwhile, if there were no downsides — but there are plenty.
2. The Most Deadly Cancers Often Are Missed.
The most common reason that cancers are missed in regular screenings is due to the nature of cancer itself. The deadliest cancers grow very rapidly. Screening can detect slow-growing cancers in their early stages, but an aggressive cancer could develop just months after screening and be too far advanced by the time you get another screening.
3. False Positives Lead to Unnecessary Treatments.
The most common drawback to cancer screenings are false positives — when you're told that your test is inconclusive and can't be verified. False positives lead to further procedures such as ultrasounds, CT scans, colonoscopies and even biopsies, which are far more invasive and could possibly even promote the spread of cancer.
Another problem with false positives is the psychological trauma of being told you might have cancer, and then having to wait months for further testing to find out for sure.
Unfortunately, false positive rates are high. If you repeat this screening test every year for 10 years, your cumulative risk of having at least one false positive goes up to 50 percent.
In addition, false positives are more common in lower-risk, younger women (this is true for all screening tests and diseases, not just breast cancer and mammography). So the potential risks at age 40 are higher, with no real added benefit.
False positive rates are high for PSA screenings as well; about 75% of the men who have a prostate biopsy based on an elevated PSA level do not have cancer; false-positive risk for pap smears is about the same.
4. Overdiagnosis Also Leads to Unnecessary Treatments.
It's true that some lives are saved due to early detection and treatment. But not all cancers are the same — some are deadly, some aren't.
The most serious harm, members of the task force said, is overdiagnosis — finding cancers that are better off not being found. Dr. Barnett Kramer of the National Institutes of Health, who was not part of the panel, described overdiagnosis as “pure harm” because it means that women are being treated with measures like chemotherapy, radiation and surgery for tumors that do not need treating.
A prime example of this is prostate cancer. Since 1975, its reported incidence has more than doubled, due to heavily-promoted screening. However, the death rate from prostate cancer has held steady at 3 percent, because most of these cancers progress too slowly to be of concern, and don't need to be treated.
And prostate cancer treatment is not without hazards. Complications from surgery or radiation are numerous. Many of these interventions are completely unwarranted, because the cancer will never develop into a harmful stage.
5. Cancer Screening (and Other Medical Procedures) May Actually CAUSE Cancer.
A recent study found that as many as two-thirds of adults underwent a medical test in the last few years that exposed them to radiation and in some cases, a potentially higher risk of cancer.
Some doctors are concerned that advanced tests that expose the patient to ionizing radiation, such as CT scans, are being over-prescribed. Some 80 million CT scans are performed annually.
Americans' exposure to radiation has increased more than 600% over the last 30 years according to a new report released by the National Council on Radiation Protection and Measurement. Most of that increase has come from medical imaging such as CT scans and mammograms.
Most women undergoing mammograms have no idea that the radiation emitted by these machines can actually cause cancer by exposing heart and breast tissue to ionizing radiation that causes DNA damage. Annual screenings only multiply your risk factor.
In another report, published in the December 2009 issue of The Archives of Internal Medicine, it was estimated that radiation from CT scans done in 2007 will cause 29,000 cancers and kill nearly 15,000 Americans. CT scans involve much higher radiation dose than conventional X-rays; a chest CT scan exposes the patient to more than 100 times the radiation dose of a chest X-ray.
There's no clear consensus among the experts. Cancer is certainly scary — and the treatments for it are as just as bad. If you have symptoms of cancer, by all means see a doctor and discuss appropriate testing.
Otherwise, do some homework and make your own educated decision. If your doctor recommends a cancer screening test, don't just go along with his recommendation. Doctors sometimes suggest these tests for the wrong reasons: it's "standard procedure," fears of malpractice, financial incentives, and even patient demand.
Next time you hear about some cancer victim who would have been saved "if only they'd had regular screening", just realize that's a mantra that doesn't hold up to close scrutiny. The statistics don't support such a statement. And, whatever you do, don't let anyone make you feel irresponsible if you decide not to undergo cancer screening.
The recent findings by the U.S. Preventive Services Task Force have given voice to a small but growing band of medical experts who are speaking out against the widespread use of cancer screenings. One of them, H. Gilbert Welch, MD, a professor at Dartmouth Medical School, gives some very persuasive arguments in his book, Should I Be Tested for Cancer? Maybe Not and Here's Why. Dr. Welch raises many issues regarding cancer screening that you should know about, and explains them in easy-to-understand language.
You can purchase Dr. Welch's book, Should I Be Tested for Cancer? from my Health & Longevity Bookstore.
Cancer is a disease that is mostly preventable — simply by following good nutritional practices and a healthy lifestyle. A diet high in antioxidants, especially one supplemented with known anti-cancer nutrients such as vitamin D, beta carotene, lycopene, quercetin and selenium, and foods such as broccoli, garlic, green tea and others, can virtually eliminate your risk of contracting cancer, even if you have inherited genetic traits that predispose you to that disease.
Search this site for more information on cancer prevention. This website has dozens of examples of the power of antioxidants in preventing cancer. You can type the words "cancer prevention" in the search box below to find them.
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