As more knowledge surfaces regarding cancer screenings, expert groups are recommending less frequent screenings for prostate, breast, and cervical cancers. It appears from numerous clinical trial studies and analysis of medical data that previous recommendations such as annual Pap tests for women be less frequent, in the case of Pap tests, every three years instead.
Studies are showing that not only may testing too frequently for cancer potentially cause harm to patients, it also appears to be a financial burden to the health care system. However, some doctors are walking the fine-line between saving money and risking a lawsuit for failure to detect a treatable cancer in time.
An article in the NYTimes.com titled, "Considering When It Might Be Best Not to Know About Cancer" breaks down new screening recommendations from expert medical groups:
- Women in their 40's do not appear to benefit from mammograms
- Women ages 50 to 74 should have mammograms every two years, instead of every year
- P.S.A. screening test for prostate cancer does not save lives and causes enormous harm
- Pap tests for women for cervical cancer should be every three years, instead of every year
Expert medical groups are now questioning if prostate cancer screenings are saving any lives at all. These groups fear that the screening often leads to disabling treatments for men, who really didn't need to treat the cancer in the first place.
A mammography study revealed that out of 138,000 cancers detected in women each year, somewhere between 120,000 to 134,000 of these cancers are already lethal and beyond being treatable or the cancers will grow slowly and not need to be treated at all.
Dr. Otis Brawley, chief medical officer with the American Cancer Society states, "Screening is always a double-edged sword. We need to be more cautious in our advocacy of these screening tests." However, many doctors and specialists, such as urologists, radiologists, and oncologists believe screening is necessary to detect and treat cancer early. Questions are also arising whether this subject is coming up simply due to costs and the modern healthcare crisis.
Regarding costs, The New England Journal of Medicine posted an article concluding $5.2 million must be spent on screening to prevent one prostate cancer death. Estimates are this amount is actually higher than that. This brings up the issue of how much to spend in order to save lives. It also creates a dilemma for doctors who will have a difficult time explaining the new guidelines to patients. Some doctors may make recommendations based on their own beliefs and the wishes of the patient's for more screening. Also, as more cancers are being determined not to be treatable, or not be a threat, the issue of cancer screening has become even more complicated; likely leaving many patients wondering when and if they should be screened.
