Cancer screening has never been shown to ‘save lives’, argue experts

A new report argues that cancer screening has never been shown to save lives, although the harms of screening are certain. The authors state this is because of reductions in disease specific mortality rather than in overall mortality. They therefore claim that overall mortality should be the benchmark against which screening is judged and call for higher standards of evidence for cancer screening.

shutterstock_304165367According to the report, there are two main reasons that explain why cancer screening reduces specific mortality rather than the overall mortality. The first reason is that studies may be underpowered to detect a small overall mortality benefit. The second reason is that disease specific mortality reduction may be offset by deaths due to the downstream effects of screening. These so called ‘off-target deaths’ are mostly seen in the screening test linked with false positive results and overdiagnosis of harmless cancers.

The authors suggest that as long as there is uncertainty about the mortality benefits of screening, people cannot be provided with information to make an informed choice. Therefore, the reports call for higher standards of evidence and transparency about the limitations of screening.

This article is interesting for anyone who is in some form associated with oncology. Especially those who provide information or care for people who need to make a decision that involves screening or not, this is a very interesting and critical article about the shortcomings of screening.

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