Think again before Cancer Screenings Doctors Warn

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Think again before Cancer Screenings Doctors Warn

Thu, 25 Aug 2005 14:58:14 +0100

 

 

( " Cancer " is always present somewhere in our bodies. Cancer cells are

abnormal cells produced by the body every day of our lives but are

normally killed by the immune system.)

 

 

Think again before cancer screenings, doctors warn

 

The Australian

Adam Cresswell, health editor

20aug05

 

HEALTHY people with no cancer symptoms should think carefully before

undergoing cancer screening tests, because diseases they detect might

never have been a threat and treating them can do more harm than good.

 

Modern tests, in which tiny tissue samples are examined under the

microscope, are so sensitive that they can pick up more cancers than

ever before, experts say.

 

But 30 to 40 per cent of all adults might test positive for some

cancers using these techniques - and tests cannot tell the difference

between cancers that will become dangerous and those that won't.

 

The result is that many patients handed a cancer diagnosis undergo

unnecessary fear and stress, and may undergo unpleasant and risky

treatments such as surgery or chemotherapy for small cancers that

might not have come to light without the test.

 

Alex Barratt, associate professor of epidemiology at the University of

Sydney's screening and test evaluation program, told The Weekend

Australian that patients should remember cancer screening " is a

two-edged sword " . While existing public screening programs for breast

and cervical cancer did have benefits, they and other cancer screening

tests also caused harm.

 

" If you have a (cancer) symptom, you should get tested - that's a

no-brainer, " she said. " The tougher decision is whether to have a test

when you are healthy.

 

" People need to understand that it's not always a good idea to have a

test to find cancer early. "

 

Associate Professor Barratt will highlight the downsides of screening

in an ABC Radio National program to be aired on Monday morning.

 

Gilbert Welch, professor of medicine at Dartmouth Medical School, in

the US, is one of the experts interviewed on The Health Report program.

 

He says that using modern techniques, " about a third of all adults

will have some pathological evidence of thyroid cancer; about 40 per

cent of women in their 40s will have microscopic evidence of breast

cancer " .

 

" As we start looking for cancer early we're sending them

(pathologists) smaller and smaller specimens, and they're really

looking at just a few cells, " he says on the radio program.

 

" And what is happening now is that we're finding these small

abnormalities that meet the pathological criteria for cancer, but

would never bother patients if they were left alone ... That's the

real conundrum with cancer screening. "

 

Many small cancers never grew, while some shrank. Others grew so

slowly the patient may die of something unrelated before the cancer

ever caused symptoms, he says.

 

Alan Coates, chief executive officer of The Cancer Council Australia,

said screening " always does harm, and sometimes does good " .

 

" We know in some diseases the good outweighs the harm - in breast

cancer and bowel cancer, and we are almost certain in cervical

cancer, " he told The Weekend Australian.

 

But in other cases, such as testing for prostate cancer, a positive

result " starts a cascade of pressure to do something about it " even

though many of the detected cancers would prove harmless if left alone.

 

Helen Zorbas, director of the National Breast Cancer Centre, said " the

evidence is very strong " that breast cancer screening programs reduced

cancer deaths among women who participated, and that seven

international trials and the World Health Organisation supported

breast screening.

 

© The Australian

 

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