Health alert on the lure of cancer screening

A rather disappointing debate recorded in Hansard on the subject of screening for cancer in men.

Unfortunately the extremely important issues of effectiveness, evidence, and potential harms seem to have become lost, e.g. “the government is committed to introducing screening for prostate cancer” – but since the evidence is mixed but much of it shows that it does more harm than good – (a large trial is ongoing in the UK at present), it seems premature to make any sort of commitment.

One MP suggested men should have “full screenings” for male cancers regularly, without citing any evidence that this is useful. Had he said research should be done on the effects of health awareness advertisements, or testing the offer of drop in clinics, I wouldn’t be complaining. But these kinds of “well man” clinics have been offered before and I am not aware of any evidence suggesting that they offer benefits in detecting cancers earlier. I am aware that in many places, they have been quietly dropped because they didn’t seem very useful.

It seems that admitting that we do not know what is best for health is not the done thing in the House of Commons. Yet this admission is hugely important.

If, instead, we keep doing things which we think, or would like to think, work but do not bother to admit our limits of knowledge and do not assess, evaluate or compare our interventions, then we will keep going round in circles, unsure where we are doing good, or harm, or wasting money. 

It is only by being brave enough to recognise when we don’t know what is best that we can find out what is. In the meantime, recommending things we think might work just isn’t good enough.

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