I found this interesting... Web-MD.. is Cancer screening risky?

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The Risks of Cancer Screening
With More Cancer Screening and Earlier Testing, Overtreatment on the Rise

By Daniel J. DeNoon
WebMD Feature

Routine cancer screening can save lives. It can also cause serious harm.

This is the "double-edged sword" of cancer screening, says Otis Webb Brawley, MD, chief medical officer at the American Cancer Society.

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"Many of these cancers we treat and cure never needed to be treated and cured," Brawley says. "They are never going to kill that patient."

At the heart of the problem is our justifiable fear of cancer. The message has been drummed into us: Find cancers early while they're still curable and get rid of them. We want out from under the shadow of the dreaded C word.

Not so very long ago, most cancers were in their deadliest, late stages by the time doctors could detect them. That's still true of some kinds of cancer, but with others -- such as breast cancer, colon cancer, cervical cancer, and prostate cancer -- advances in cancer screening now make it possible to find many tumors in their earliest stages.

Some of these early cancers will become killers. Others never will. But there's no reliable way to tell which is which. Doctors feel their hands are forced.

"We are treating lesions that never would come to medical attention were it not for increasingly sensitive medical tests," says Barnett S. Kramer, MD, MPH, associate director for disease prevention at the National Institutes of Health.

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Biopsy Harm

Maybe it's already happened to you.

You feel perfectly fine as you walk into the doctor's office for a check-up. You get a routine screening test. Later, you get a call. The test says you may have cancer. You'll need more tests to be sure.

Yesterday you were a healthy person. Today you might be a cancer patient. And you won't find out for sure until you have a bit of your body removed with a needle or scalpel or scope -- a biopsy -- to find out if it's cancer.

Maybe that biopsy didn't hurt much. Maybe it did. Or maybe you're one of the unlucky few who suffered a serious injury, such as a perforated colon or a blood infection.

But now you have a new problem. You anxiously wait for the next call, the one that will tell you whether there really are cancer-like cells in your body.

If it's not cancer, you may breathe a sigh of relief. If it is cancer, you might think the test saved your life. But maybe not.

The vast majority of screening-triggered, cancer-positive biopsies detect cells in the very earliest stages of becoming cancers.

That's good, isn't it? Early-stage cancers usually are curable. But there's a catch, Kramer says.

"Unfortunately, right now we are diagnosing a large number of people without precise enough knowledge to spare those who don't need to be treated from treatment," Kramer says. "We treat them, but we have to accept the possibility that there is overtreatment."......

.....Why? As Brawley notes, many of the cancers we're detecting and curing would never have killed. Some cancers are, or become, benign. Some "spontaneously remit," meaning they go away. Some -- doctors call them "indolent" -- grow so slowly that a person would die of something else.

"Overtreatment is treatment that was not necessary at all because the tumor did not need to be treated," Kramer says. "There is more and more evidence that there is an increasing pool of these tumors."

The Downside of Cancer Treatment

No question: Cancer treatment saves many lives. But it's serious, often involving surgery, toxic drugs, and/or radiation. Treatment can scar and damage bodies, increase the risk of other cancers, and reduce the quality and length of a person's life.

It's worth it if it saves your life. But what if it doesn't? Many people have to accept the risks of routine cancer screening in order for one person to benefit. And when a cancer is found, treatment is no walk in the park.

"We do major surgery. We give radiation, a known carcinogen. We give chemotherapy, also a known carcinogen," Kramer says. "It is difficult to make a healthy person better than they are, and that is the very high bar screening tests must clear."

Yet most doctors would agree that it would be wrong not to treat people with early cancers, says Stefan Gluck, MD, an oncologist at the University of Miami Sylvester Comprehensive Cancer Center.

"With any cancer, even the smallest one can be very aggressive," Gluck says. "I do not believe it is wrong to find cancer early and get rid of it."....

...To Screen or Not to Screen?

Some people are at higher risk of cancer than other people. For example, a woman may have inherited genes that raise her risk of breast cancer. Or she might be a smoker, raising her risk of lung cancer.

For people at risk of cancer, the benefits of screening often outweigh the harms. For those not at risk, deciding on whether to undergo cancer screening can be a close call.

The USPSTF recommends routine screening -- that is, for people at normal risk -- for only three cancers:

Breast cancer screening mammography is recommended for all women aged 50 to 74. Women under age 50 must weigh the benefits and harms before deciding to undergo screening mammography.

Colon cancer screening is recommended for all adults from age 50 until 75.

Cervical cancer screening every three years via Pap smear is recommended for all women aged 21 to 65.

At age 30, women may opt for screening every five years with a combination of Pap tests and testing for human papillomavirus (HPV).

The USPSTF says there's not enough evidence to recommend for or against routine screening for bladder, lung, oral, and skin cancers. The panel advises against routine screening for ovarian, pancreatic, prostate, and testicular cancers.

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Last Edited by CitizenPerth™ on 10/29/2013 11:19 PM