The WSJ on the lung cancer screening controversy. What do patients prefer?
Does screening for cancer really prolong your life? Or does it just tell you sooner that you have cancer, without changing whether you ultimately live or die from the disease? . . .. . . regardless of the debate, patients want to be diagnosed early, when their cancer is most treatable.
However, keep in mind that early treatment of cancer does not necessarily mean an improvement in survival.
Update:
The NY Times also with an excellent article on this.
Related posts:
- The US has the highest cancer survival rates
- USA Today op-ed: Not all cancer screening tests lead to better treatment
- How screening for prostate cancer can be a gamble, and why either screening or not has consequences
- 15 cancer screening posts you may have missed
- How does cancer screening cause harm?
- Early cancer screening isn’t always better
- Prostate cancer screening in men over 75
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{ 2 comments }
I totally agree, and I am just a mere layperson.
Screening also does not equal prevention.
But the mantra of screening, early detection and early tx has been remorselessly drummed into the public’s head. Changing this mindset is not going to be easy, because it is so entrenched.
One reason that changing this mindset is not easy is because it is shared by some subset of doctors – as is clear from the present debate. The doctors who share this mindset go on TV, on the radio, give interviews, recommend screening, recommend “talking to your doctor about screening”. saw the doctor from Fox’ Sunday Housecall go on TV and recommend lung cancer screening with CT some years ago. Lots of people watch this show.
The desease advocacy groups perpetuate this mindset and they often quote doctors that work with them. When any cancer for which there is no test is discussed, it is often mentioned that the absence of a test to detect it early is the reason why people die from it.
I’ve seen doctors’ blogs posts that say how 5-year survival is higher when the desease X is detected earlier. I am just a layperson, but I couldn’t resist posting and asking if he had ever heard of the lead-time bias.
I think the only way to change public mindset is to stop omitting risks when discussing screening, explaining the difference between survival and mortality, discussing variable course of the desease, and explaining the benefit of any screening in absolute rather than relative numbers. Yes, there is no time for this during office visits. But there is no such restrictions on providing information on websites. I think just having more balanced presentation of benefits and risks of screening on popular medical websites and in the media may have some effect on public’s mindset. Maybe not much of an effect, but some.
Some time ago AMA Virtual Mentor’s article when discussing a case of a patient’s refusal to do recommended screening and doctor’s reaction, mentioned that in today’s world belief in screening crossed the line from science into religion with “believers” wanting to convert everyone else. It is very difficult to change mindset of a believer.
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