Doctors and patients still in the dark about cancer screening dangers

A lot of people have trouble with any criticism of routine cancer screenings. But science is about observing and reporting the facts. Not wishful thinking.

Sure — we all wish routine cancer screenings could save lives. But as I reported last month, the science shows most routine screenings only detect small, harmless growths that would never have gone on to harm or kill the patient.

So while the industry promotes the idea that screenings “save lives,” the facts show the patients’ lives were never at risk in the first place.

Hard facts about cancer screening risks largely unknown or ignored

Another one of the hard facts about routine cancer screenings is that they have many risks. In fact, according to a new study conducted by researchers from the University of Michigan Health System, many doctors don’t tell their patients about these risks. Often because they don’t know about the risks themselves!

But according to Dr. Tanner J. Caverly, cancer screening tests “have risks as well…so if doctors are going to use them to guide patients, they have to be clear” about the risks.

Vast majority of cancer screening guidelines are biased

For this new study, Michigan researchers examined 55 clinical cancer screening recommendations — such as those made by the American Cancer Society and the U.S. Preventative Services Task Force.

They found that 69 percent of the screening recommendations examined didn’t accurately present the harms and overstated the benefits. Just 31 percent provided accurate explanations about the risks and dangers.

But even among this 31 percent, 51 percent of them presented the risks in a skewed fashion — making the benefits appear greater than they are, and the risks appear smaller.

So, overall, only a paltry 14 percent of guidelines presented accurate, balanced, and fair assessments of the real risks of cancer screenings.

Of course, routine mammography is one example of a screening test with vastly overstated benefits.

As I’ve told you before, in 2014, a major, 25-year long Canadian clinical trial found no difference in death rates from breast cancer among younger woman who had regular mammograms and those who did not. In other words, annual mammograms for women ages 40-59 do not reduce death rates any better than do breast physical exams.

After that study came out, the U.S. Preventive Services Task Force began recommending women wait until age 50 years to get their first mammogram. And in a bow toward the real science, the American Cancer Society even made what they termed a “major policy shift.” It now recommends women wait all the way until they’re 45 years old to have their first mammogram.

But when you really break down the data, it means mammograms are useless at any age. And they’re especially useless in older women because women who get breast cancer typically survive 20 years or more.

Furthermore, the cheerleader organizations, such as the Susan G. Komen Foundation, systematically ignore women who have the rare, aggressive, metastatic breast cancers that do really kill. These women with metastatic breast cancer say they have been marginalized by Komen and the entire “feel-good” breast cancer industry. No one wants to hear that a routine screening couldn’t save their life…so they’re kept off the platform.

The cancer industry arguably treats men even worse. Doctors once considered the prostate specific antigen (PSA) test an appropriate screening for prostate cancer. But the science shows doctors should never order it routinely. This test results in far too many useless, painful biopsies and far too many surgeries to remove the prostate.

New study misses mark on colonoscopies

The Michigan researchers were right on track up until they tackled routine colonoscopies and colon cancer. They credited increased use of routine colonoscopies over the years with the significant drop in colon cancer.

But zero real evidence suggests the routine use of colonoscopy cancer screening specifically is really responsible for the drop in colon cancer.

For routine colon cancer screening, I recommend opting for a simple test that detects blood in the stool, such as the FIT test. These tests are far safer and just as effective when it comes to detecting colon cancer. Plus, they don’t have the contamination issues, don’t require general anesthesia, and don’t involve abdominal perforations and lacerations — all of which I have seen far too frequently in my practice as a consulting forensic pathologist.

In fact, a recent study from Yale found that two percent of “low-risk” patients age 65 and older ended up in emergency rooms with complications of colonoscopy. Yet, screening guidelines recommend continuing them up to age 80. My own primary care doctor, who is better at doing math, fortunately, recommends stopping them by age 70 years. He also recognizes the sound practice of administering a simple stool sample test at home before resorting to a full colonoscopy, if still needed.

Overall, the Michigan study made some excellent points. And I was pleased to see it appear in the Journal of the National Cancer Institute (JNCI). The outside, independent editors and scientists at JNCI deserve credit for publishing the actual science on this hot topic — even when it runs contrary to the cancer industry’s propaganda that “routine screenings save lives.”

I found I could rely on the JNCI 30 years ago to publish my scientific study about the faulty beta-carotene theory of cancer after my political bosses at the National Cancer Institute itself tried to block it.

Now — if we can just get a few more doctors and patient advocacy groups to actually read the Michigan study and face the truth about these useless, routine screenings, we might actually make some real progress.

 

Sources:

  1. “Docs Failing to Present Pros, Cons of Cancer Screening: Study,” Newsmax (www.newsmax.com) 2/23/2016
  1. “Presentation of Benefits and Harms in US Cancer Screening and Prevention Guidelines: Systematic Review,” Journal of the National Cancer Institute 2/24/2016; 108 (6): djv436
  1. “Annual screening does not cut breast cancer deaths, suggests Canadian study,” British Medical Journal, published on-Line, 2/11/2014

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