“It is time to stop this screening nonsense”

North America is not catching up: I think they are getting ahead in terms of sense about screening.  PSA screening in the UK is available, and meant to be about ‘choice’, even then health charities say they  “Supports the right of every man over 50 – and younger men at higher risk – to make an informed choice about the PSA test: Supports the right of every man over 50 – and younger men at higher risk – to make an informed choice about the PSA test”

A linked editorial in The Journal of Family Practice says :

“it is time to stop this screening nonsense. The facts speak for themselves: A trial of 182,000 patients finds in a post hoc analysis of a very narrow population that death can be averted in one of 723 individuals who are screened.2 What about the complications associated with diagnosis, work-up, and treatment?

It is time for urologists and primary care physicians to tell patients that PSA screening is unlikely to benefit them.

Some of you will suggest that we counsel patients about PSA testing to facilitate informed decision-making. But do we advise patients to play the lottery or try futile therapies?”

Indeed.

One Response to ““It is time to stop this screening nonsense””

  1. Elizabeth (Aust) October 8, 2011 at 4:59 am #

    I think every “extra” routine exam or cancer screening test carries risk and that’s why I won’t have anything unless it passes “my” risk v benefit test.
    Some argue that you can have the test and then decide what to do if you get an abnormal result – not many of us are happy to walk away and leave something “abnormal” sitting on our file. Those who do probably spend a lot of time worrying about it before re-testing and worrying some more….do the believe the first “abnormal” test or second “normal” test? What to do if the second is “abnormal”?
    Most are eventually passed down the line to a specialist for an investigative procedure or biopsy. Many women get caught on what I call the “abnormal pap test merry-go-round” and in America where doctors have a reputation for extreme over-screening and over-treatment, you often read of women (including some very young) talking about their pap tests, re-testing, colposcopies, LEEP, cone biopsies etc that may extend over many years, and some will finally agree to a hysterectomy because they keep getting “abnormal” pap tests, not because they have a diagnosis of cancer! America also tests women not yet sexually active from age 21, so these poor women also run the risk of getting caught up on this miserable cycle.
    It might be a great deal for doctors and day procedure centers, a lousy deal for women – turning heaps of healthy people into permanent patients.
    Aside from anything else…what a horrible way to live your life!
    I read that the Americans Preventative Task Force will not be recommending PSA testing for healthy men in the future – it does not save lives and often leads to painful procedures that can leave men incontinent and impotent. This is the same group that scaled back mammograms last year. These changes cause a lot of concern for many who believe more screening or any screening is best…if it’s not evidence based, it’s not a good idea. I won’t have screening for ovarian cancer – it’s a silent and deadly disease BUT, there are no reliable screening tests. I don’t think there is anything more to discuss, if it doesn’t work and exposes me to risk…no deal.
    Do charities have a bias in what news they report to their supporters?
    Definitely – I think some of these charities are a major part of the problem…misinforming and scaring people and I query their motives – power and politics seem to be a major focus.

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