Too many cancer screenings can not only result in the over-diagnosis of harmless cancer cases, but also skew the medical community's perception about what increases the risk of developing harmful types of cancer, according to an op-ed published in the Annals of Internal Medicine.
Here are three things to know.
1. In the article, authors Gilbert Welch, MD, a professor with the Dartmouth Institute for Health Policy and Clinical Practice in Hanover, N.H., and Otis Brawley, MD, chief medical and scientific officer and executive vice president of the American Cancer Society, argue excessive cancer screenings based on suspected risk factors induce a "self-fulfilling prophecy." This is particularly true, the authors argue, with prostate cancer, as men with a family history of the disease are screened for it at higher rates.
"If we biopsied men without a family history of prostate cancer at the same rate that we biopsy men with a family history, we'd find more prostate cancer in them as well," Dr. Welch told STAT. "Family history influences how hard we look for prostate cancer and therefore how much we find. The risk factor becomes a self-fulfilling prophecy."
2. The authors also apply this logic to breast cancer screening practices. Women who live in communities with the highest 20 percent of education and income have double the chance of being diagnosed with breast cancer, according to a study published last February in the journal Cancer Epidemiology, Biomarkers & Prevention. However, women in these wealthier communities have increased access to the healthcare system and are therefore more likely to receive mammograms, breast ultrasounds and MRIs. This increased scrutiny increases the likelihood of cancer diagnosis.
3. In the article, Dr. Welch and Dr. Brawley call for the medical community to focus less on risk factors for developing cancer and more on risk factors associated with death from cancer or the development of metastatic forms of the disease, as these are two concrete outcomes.
To read the full article, click here.
To read STAT's coverage of the article, click here.
More articles on quality:
Intermountain Healthcare's 83 clinics become patient-centered medical homes
1st-year hospitalists' patients have higher mortality rates than more experienced counterparts
Geisinger Holy Spirit Hospital cited for safety issues after death of restrained patient