For many years, medical experts have been urging Americans to seek regular and timely screenings for a variety of cancers, including cancers of the prostate, colon, cervix, and breasts. Now, many experts are publicly contradicting the generally accepted axiom, concluding that more testing is not necessarily useful, cost effective, or indicative of better outcomes.
What Is Usually Recommended?
To date, most doctors and researchers have recommended certain screening tests on a regular basis, although there are differences in the details of these recommendations:
• PAP smears have long been the gold standard for the early detection of cervical cancer.
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• Mammograms are often recommended every two years for women over 50, and only for women under 50 who have particular risk factors. Meanwhile, others recommend mammograms for any women over 35, but opinions differ based on the organization.
• PSA (Prostate Specific Antigen) blood tests and digital prostate exams are generally urged for men over 40, although some professionals question the efficacy of these tests.
• A colonoscopy every five years is the widely accepted norm for the early detection of colorectal cancers in those Americans over 50, as well as those aged 40 and above with a positive family history and other risk factors.
• CT scans for the detection of lung cancer are sometimes performed for those thought to be at risk.
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What is the Current Controversy?
Recent reports and publications show widely differing opinions regarding the efficacy and overall need for certain cancer screenings. Some experts state that certain tumors are too slow growing to be life-threatening, thus early detection is an unnecessary expense that leads to expensive and equally unnecessary treatment.
Other experts state that many cancer screenings are over-publicized and that too many promises are made vis-à-vis their potential to actually save lives. Additionally, some study data reveal that survival rates are virtually unchanged for certain types of cancers, despite early detection.
Reading through recent articles on this subject, it seems that colorectal and cervical cancer screenings are widely accepted as being the least controversial of all cancer screenings generally practiced in the United States.
PSA tests for prostate cancer and the question of whether women need mammograms during their 40s are two areas of great current controversy, with some government agencies calling for an end to the PSA screening altogether, an assertion based on data showing that few—if any—lives are actually saved by the test.
Additionally, certain types of mammograms are now more powerful than ever, detecting ever smaller tumors that may not have threatened a woman’s life in the first place. However, with the detection of that tumor, treatment is then medically necessary, especially in light of patients’ fears, and many question the usefulness of such intervention.
Striking a Balance
Apparently, government agencies and health professionals are striving to strike a balance when it comes to cancer screening. With the constant collection of data related to the ability of such screenings to actually save lives or improve mortality and morbidity, many experts are being led to believe that we have potentially been overzealous in our pursuit of early detection. Such rampant testing can indeed contribute to the rising cost of health care, thus those with an interest in containing costs would like to do so without compromising Americans’ health.
What Should I Do?
Informed decisions about which cancer screenings to undergo and which ones to eschew should be based on your personal health history, your family history, and a thoughtful discussion—or series of discussions—with a doctor that you trust.
Reading about the latest recommendations for cancer screenings can be confusing, especially when very trusted experts and organizations differ in their opinions. Thus it’s important for the average consumer to become conversant with the differing recommendations—as well as the current controversy surrounding them—and bring this information to your doctor for a very important ongoing conversation.
