Avoid Eight Cancer Screenings, Says Consumer Reports
Editor's ChoiceMain Category: Cancer / Oncology
Article Date: 03 Feb 2013 - 0:00 PST
Avoid Eight Cancer Screenings, Says Consumer Reports
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Consumer reports evaluated eleven cancer screening tests, and has found that most of us should avoid eight of them. The non-profit consumer's organization says that most preventive cancer screenings are oversold and may confuse rather than clarify.
In a new report, the authors say that not all cancer screening tests are helpful. In fact, they added that some of them may be harmful.
Consumer Reports emphasizes that its advice regarding avoiding eight cancer screenings is directed at those who are not at high risk and do not have signs and symptoms of cancer.
The full report is available in the March issue of Consumer Reports.
The most effective tests
The following cancer screening tests, according to the authors of the new report, are the most effective and received the highest ratings:- Cervical cancer - received the highest score. It is recommended for females aged from 21 to 65 years. Females younger than 21 should skip the Pap smear (cervical cancer screening), because this type of cancer is extremely rare and the tests are not accurate for this age group. In March 2012, the United States Preventative Services Task Force issued its guidelines for cervical cancer screening.
- Breast cancer - received the second highest score for females aged from 50 to 74 years. However, women in their forties and 75+ should consult with a health care profesional to determine whether screening is advisable, based on their risk factors.
- Colon cancer - received the highest score for men and women aged from 50 to 75 years. Lower scores were attributed for patients aged 76 to 85. A low score was given for people aged 86+. The lowest score went to patients up to the age of 49. Younger patients should only consider testing for colon cancer if they are deemed to be high risk. The disease is extremely rare among those younger than 50.
In March 2012, the American College of Physicians published a new guidance statement in the Annals of Internal Medicine, concerning colorectal cancer screenings.
Do not waste your time on the following tests
The majority of people are advised to avoid the following cancer screening tests:- Bladder cancer - consists of a urine test, which looks for blood or cancer cells
- Lung cancer - the patient undergoes a low-dose CT scan. American Cancer Society guidelines advise doctors to only recommend lung cancer screening for older people who have smoked for many years.
- Oral cancer - a health care professional, such as a dentist, carries out a routine visual exam of the mouth. The American Cancer Society recommends this be done as part of a patient's normal routine oral care.
- Ovarian cancer - received the lowest rating for females of all ages because it is not very effective. Only high-risk women need to be tested. In September 2012, the US Preventive Services Task Force (USPSTF) recommended against routine ovarian cancer screening because the risks are greater than the benefits.
- Prostate cancer - consists of a blood test. Levels of prostate-specific antigen (PSA) are measured. According to the American Cancer Society, patients should discuss with their doctors whether they should undergo this test. In May 2012, the US Preventive Services Task Force concluded that the PSA blood test "may benefit a small number of men but will result in harm to many others".
- Pancreatic cancer - received the lowest score for men and women of all ages. Only those at high risk should consider pancreatic cancer screening, which consists of image tests of the abdomen or genetic tests. There is no current test that is able to detect the disease in its early stage (curable stage).
- Skin cancer - a dermatologist carries out a visual exam of the patient's skin and looks out for signs of melanoma (deadly skin cancer). According to the American Cancer Society, this should be part of a routine check-up done by doctors.
- Testicular cancer - received the lowest score for men of all ages. Only men at high risk should be considered for testicular cancer screening. The majority of testicular cancers that are detected without screening are curable.
John Santa, M.D., M.P.H., director of the Consumer Reports Health Ratings Center, said:
"We know from our surveys that consumers approach screenings with an 'I have nothing to lose' attitude, which couldn't be further from the truth. Unfortunately some health organizations have promulgated this belief, inflating the benefits of cancer screenings while minimizing the harm they can do.
To help clarify when most consumers should use cancer screenings and when they should skip them, we rate each screening and whether it is useful for a specific age group. We also try to identify some high risk factors that may make screening a reasonable choice."
Not even doctors can always agree on which screening should be classed as necessary, Dr. Santa explained.
Consumer Reports found that the proportion of patients who undergo screenings for colon-cancer varied widely within the states of Wisconsin, Minnesota and Massachusetts, from 47% to 95%, depending on which medical groups were investigated.
Patients should ask their doctors the following questions
The authors of the report advise patients to ask their health care professional a series of questions before agreeing to undergo any kind of cancer screening test.Below are some possible questions:
- Will a positive test result save my life?
- Am I at a higher risk of developing this cancer than the rest of the population? If so, why?
- How often do patients get false-positive results for this type of screening?
- Are there any other tests available which are equally good?
- If my results come back positive, what happens next?
Overall, preventive cancer screening rates have dropped in the United States
Over the last ten years, the number of Americans seeking preventive cancer screening has dropped, researchers from the University of Miami Miller School of Medicine reported in Frontiers in Cancer Epidemiology in December 2012.The authors believe that reductions in workers' insurance cover, plus the failure of leading bodies to agree on screening guidelines have contributed to the fall.
Cancer killed over 570,000 people in the USA in 2011.
While there has been a drop in advance cancer diagnoses in America over the last decade, the number of cancer survivors returning to work has risen. The researchers believe that "keeping to a cancer screening schedule could be an important factor, as this helps detect secondary tumors early."
Written by Christian Nordqvist
Copyright: Medical News Today
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Visitor Opinions (latest shown first)
Informed consent is missing from women's cancer screening
posted by EEB on 22 Apr 2013 at 8:29 amWhat we're not told is that cervical cancer is rare, always was and was in natural decline before testing started, so very few can benefit, 0.65% is the lifetime risk. Yet the lifetime risk of referral for colposcopy/biopsy is a huge 77%, this shocking figure is caused by false positives made worse by serious over-screening.
Since the 1960s the Dutch have offered 6-7 pap tests, 5 yearly from 30 to 60, and they have the lowest rates of cc in the world and refer far fewer women for biopsies/over-treatment.
Now we know that only those women aged 30 to 60 who are HPV+ and at risk have a small chance of benefiting from a 5 yearly pap test. Most women are HPV- and cannot benefit from pap testing. The new Dutch program is 5 hrHPV primary tests offered at ages 30,35,40,50 and 60 and only the roughly 5% who are HPV+ will be offered a 5 yearly pap test.
As a low risk woman with a near zero risk of cc it was an easy decision to pass on screening...a decision made over 30 years ago. Dutch women are also, already using a long overdue self-testing option, the HPV self-testing device, the Delphi Screener.
Population pap testing worries and harms too many women and is inefficient...why would the vast majority of women who are HPV- wish to have a lifetime of unnecessary pap testing with the high risk of potentially harmful over-treatment. The use of pap and HPV tests on all women is unhelpful and generates the most over-investigation. HPV primary testing should stand alone.
Breast screening - I've declined. Women once again do not get balanced and complete information and there is no respect for informed consent. The evidence is concerning, about 50% of screen detected cancers are over-diagnosed, any benefit of screening is almost certainly wiped out by women who die from lung cancer and heart attacks after radiotherapy and chemo. (Prof Michael Baum, Breast Screening: The effect of Radiotherapy and Chemo: BMJ, 2013)
The fall in mortality from breast cancer is about better treatments, not screening. Breast screening also, does not save breasts, as often claimed by pro-screeners.
Thankfully, the Nordic Cochrane Institute have produced an excellent summary of all of the evidence, it's at their website. Prof Michael Baum has also written some helpful articles.
Now I'll consider bowel screening, but it means doing my own research, I've found official sources of information to be incomplete and unreliable. Although, men received real information on prostate screening and doctors were reminded to obtain informed consent. It seems a double standard is in place or perhaps, paternalistic attitudes still exist in women's healthcare. Sadly, IMO, powerful vested and political also, exist in women's cancer screening.
So I think we need to be very careful with cancer screening, do our own research and make sure we understand what we're agreeing to...we can say No, it's our choice. It should be about informed consent and evidence based screening, not screening targets, maximizing profits, medical excess and protecting programs. (not women)
Also, the routine pelvic and breast exam is not evidence based and not recommended in many countries. The routine breast exam - no evidence of benefit, but it leads to excess biopsies. The routine pelvic exam is of poor clinical value, is not a screening test for ovarian cancer and carries risk, even unnecessary surgery. Dr Carolyn Westhoff, American obgyn partly blames this exam for your high hysterectomy rates, 1 in 3 will have one by age 60, more than twice the number of countries that don't do this exam...and for the loss of healthy ovaries after false positive bimanual exams. More should be done to warn women about these exams and to stop doctors who coerce women into these exam in return for the Pill. The only clinical requirements for the Pill is your medical history and a blood pressure test. The Pill should be delinked from cancer screening.
Poor advice on cancer screenings
posted by G Horner on 4 Feb 2013 at 2:55 pmWow! I read some really poor advice in this article! My wife didn't have an Ovarian cancer test... until her lung collapsed and she was diagnosed stage 4 (not curable)at age 59.
I did have regular PSA tests and my cancer was caught at stage I in 2005.
It's not the testing, it's poor doctoring when results are not normal.
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