Avoid Eight Cancer Screenings, Says Consumer Reports

Editor's Choice
Main Category: Cancer / Oncology
Article Date: 03 Feb 2013 - 0:00 PST



Current ratings for:
Avoid Eight Cancer Screenings, Says Consumer Reports

Patient / Public:3 stars

3 (4 votes)

Healthcare Prof:5 stars

4.67 (3 votes)

Article opinions: 2 posts

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:

Do not waste your time on the following tests

The majority of people are advised to avoid the following cancer screening tests: The medical team gathered and examined data from medical studies, talked to experts, and surveyed over 10,000 readers. They also talked to patients.

A more detailed analysis was done on evidence-based reviews from the US Preventive Services Task Force, an independent group which is supported by the HHS (Department of Health and Human Services).

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:

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
Not to be reproduced without permission of 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 am

What 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.

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Poor advice on cancer screenings

posted by G Horner on 4 Feb 2013 at 2:55 pm

Wow! 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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