For quite some time we’ve been told that one of the best tools in fighting breast cancer and prostate cancer was regular breast cancer screenings such as mammograms and PSA screenings. Now, the American Cancer Society believes that the benefits of such screenings may have been overstated. This new message comes in the wake of an analysis of the risks and benefits of breast cancer screening published in The Journal of the American Medical Association. In a front page article this morning, the NY Times notes, “In it, researchers report a 40 percent increase in breast cancer diagnoses and a near doubling of early stage cancers, but just a 10 percent decline in cancers that have spread beyond the breast to the lymph nodes or elsewhere in the body.”
Dr. Otis Brawley, chief medical officer of the American Cancer Society put it bluntly, “I’m admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated.”
Screenings fail to distinguish between cancers that if left undetected cause no harm and do not grow and cancers that are aggressive and fatal. According to the NY Times article, “researchers are finding cancers that do not need to be found because they would never spread and kill or even be noticed if left alone. That has led to a huge increase in cancer diagnoses because, without screening, those innocuous cancers would go undetected.At the same time, both screening tests are not making much of a dent in the number of cancers that are deadly. That may be because many lethal breast cancers grow so fast they spring up between mammograms. And the deadly prostate ones have already spread at the time of cancer screening. The dilemma for breast and prostate screening is that it is not usually clear which tumors need aggressive treatment and which can be left alone. And one reason that is not clear, some say, is that studying it has not been much of a priority.”
Obviously, this is a significant shift in the detection of breast and prostate cancer and may lead to public confusion concerning the benefits of mammograms and other screenings. The cancer society has promised to issue new guidelines early next year.
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