We are frequently told about the importance of screening for cancer and that if detected early it can be treated better and our quality of life and survival are better. It may be shocking to learn that not all experts recommend regular screening tests for cancer.
As consumers we are trained to think it is irresponsible to skip regular health screening and testing, so these new findings may cause confusion and anger. Before making a hasty decision to stop screening, it would be helpful to understand when cancer screening works best.
One of the most successful cancer screening programs has been the pap smear for cervical cancer. The test is affordable and has virtually no side effects. It is effective at detecting cancerous (malignant) and non-cancerous (benign) conditions with consistent accuracy. It has been effective in detecting potentially deadly cancers before any physical symptoms are noticed. Cervical cancer screening allows women to make decisions about their treatment early and when the chances of successful treatment and cure are highest.
On the other hand, the benefits of the prostate specific antigen (PSA) blood screening test for cancer are debatable. Its accuracy is less specific, meaning men who undergo a PSA test may be referred for more invasive screening studies because the PSA test results were not conclusive. Only 20-25% of men with a high PSA score who undergo prostate biopsy turn out to have cancer. Prostate biopsies may carry an unnecessary risk of infection, bleeding or other post-procedure complications. Current screening tests cannot distinguish between deadly cancers and those that are slow-growing or potentially not harmful.
No one is arguing that cancer screening tests save lives and everyone knows someone who has been diagnosed with cancer from a screening test that was treated early and lived a long and healthy life. But when it comes to establishing screening guidelines for a diverse population, public health officials must weigh the medical and economic costs against the benefits for people at different risk levels. There are risks associated with screening and with not screening.
What is important to remember is that screening guidelines are intended to be a starting point for a discussion between the patient and their physician. The individual patient’s need for testing should be based on specific risks, the patient’s current health status, their family history of cancer, and so forth. To stop taking advantage of regular screening for cancer is not a good solution. Patients should empower themselves by becoming aware of the recommended guidelines and then making an informed decision to screen, or not to screen, with the help of their physicians and healthcare providers.
To learn more about the nationally recommended screening guidelines for many types of cancer, click here.
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