Cancer society’s messages on screening conflict

Oct. 22nd, 2009 by Andrew Van Dam
Filed under: Conflicts of interest, Hot Health Headline, Public health 

The New York Times‘ Gina Kolata reports that the American Cancer Society, a longtime defender of early detection and cancer screening, is planning to release an online message next year “to emphasize that screening for breast and prostate cancer and certain other cancers can come with a real risk of overtreating many small cancers while missing cancers that are deadly.”

MRI
MRI entrance, photo by Scott & White Healthcare via Flickr.

“We don’t want people to panic,” said Dr. Otis Brawley, chief medical officer of the cancer society. “But I’m admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated.”

The ACS’ change of heart on breast and prostate screening was inspired, in part, by a recent analysis published in JAMA.

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. With prostate cancer, the situation is similar, the researchers report.

In an interesting side note, Kolata includes a quote from Colin Begg, a biostatistician at Memorial Sloan-Kettering Cancer Center in New York, that shows a different perspective on media coverage of the screening debate.

“I am concerned that the complex view of a changing landscape will be distilled by the public into yet another ‘screening does not work’ headline,” Begg said. “The fact that population screening is no panacea does not mean that it is useless,” he added.

Kolata’s story was published on Tuesday. On Wednesday, the ACS released a statement from Brawley in which he says the organization stands by its screening recommendations. In the statement, Brawley says ACS “stands by its recommendation that women age 40 and over should receive annual mammography” and that its recommendation that men consult with their doctors to “make an informed decision about whether or not prostate cancer early detection testing is right for them. ”

The LA Times‘ Booster Shots blog has more, as does NPR’s health blog.

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Comments

3 Comments on Cancer society’s messages on screening conflict

  1. Kok Siong Chen on Thu, 22nd Oct 2009 11:26 PM

    2. Hi! I’m Kok Siong, a student from University of Malaya, taking Genetics and Molecular Biology course. Can you please explain to me about the process of cancer screening? How can this process cause a risk of overtreating small cancers while missing cancers that are deadly as you mention in the article? I’m writing a blog about Cytogenetics and Cancer and hope to increase the awareness of people on these kinds of diseases which can be prevented. Thanks for information.

    Regards,
    Kok Siong Chen
    Cytogenetics and Cancer

  2. Screening for Cancer Questioned « Boston Health News on Thu, 29th Oct 2009 3:48 PM

    3. [...] did they? This blog item from the Associations of Health Care Journalists notes that ACS backpedaled the next day with little notice. See their links for more details. [...]

  3. Carol Hambarian on Sun, 8th Nov 2009 5:52 PM

    4. Talk about conflict of interest. …. As a twice breast cancer survivor, I’m here to tell you that all the running, the ribbons, the pink cereal boxes, are for naught. What is not known is that you become a liability to employers when it is known that you have a history of cancer. So all the ladies that are running and assembling for ralleys, are only advertising the fact that they are liabilities (to the Employers). Insurance companies don’t care either. Neither does “federal” COBRA. My employer dropped me from health insurance twice without telling me., and got away with it. I found out both times through a third party. I had to pay $$$$ retro-actively for my insurance. So..no pinks, no running, no Health Care Reform.

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