Recently, Dr. Otis Brawley, ACS chief medical officer, stepped up and said the most astonishing thing to the New York Times: “I’m admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated.”
That last sentence is the kind of thing you expect to hear from, well…me, but NEVER from ACS.“The advantages to screening have been exaggerated.”
But my complete astonishment at seeing that admission cannot be exaggerated.
Thinking and rethinking
For years, I’ve been telling you that mammogram screening and PSA tests for prostate cancer screening are inadequate, unreliable, and even dangerous for some patients.
These screening methods aren’t exactly useless, but for many years they’ve been promoted by the medical mainstream as the gold standard. Period. No discussion.
Suddenly, we have a real discussion. And it’s been prompted by a mainstream source that’s about as mainstream as you can get: the Journal of the American Medical Association.
In just eight words, the title of the JAMA article rocked the cancer world: “Rethinking Screening for Breast Cancer and Prostate Cancer.”
Why the rethinking? One word: overdiagnosis.
Mammography and PSA testing have a similar flaw. Both screening methods detect harmless tumors along with dangerous tumors. But in many cases those harmless tumors are treated as life threatening, so doctors and patients often go ahead with unnecessary surgery, chemotherapy, and radiation.
As one National Institute of Health official told the Times, “Overdiagnosis is pure, unadulterated harm.”
Here’s another quote from the Times – again from Dr. Brawley of ACS: “…we have always worked to treat cancer or to find cancer early. And we never sat back and actually thought, ‘Are we treating the cancers that need to be treated?'”
You WHAT?! You NEVER sat back and asked that question? That’s a stunning admission! I think it’s safe to say that virtually every cancer patient ASSUMES that his doctor is asking EXACTLY that question before going ahead with any treatment.
Dr. Brawley also told the Times: “We don’t want people to panic.”
I’ve got a strong hunch he’s not talking about the average person there. I mean, why would you or I panic about getting fewer mammograms or PSAs? No, there’s only one group that would be panicking right now… the professionals who make their living promoting and giving mammograms or chemotherapy. Imagine what the lack of over-diagnoses could do to their bottom lines.
“Cancer Society, in Shift, Has Concerns on Screenings” Gina Kolata, New York Times, 10/21/09, nytimes.com
“Rethinking Screening for Breast Cancer and Prostate Cancer” Journal of the American Medical Association, Vol. 302, No. 15, 10/21/09, jama.ama-assn.org
Jenny Thompson is the Director of the Health Sciences Institute and editor of the HSI e-Alert. Through HSI, she and her team uncover important health information and expose ridiculous health misinformation, most notably through the HSI e-Alert.
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