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Some screening tests should not be advocated
February 05, 2004Certain screening tests for cancer are of unproved value and should not be advocated, argues a senior doctor in this week's BMJ.
The blood test for cancer of the prostate (PSA) is an example, writes Professor Malcolm Law at the Wolfson Institute of Preventive Medicine. Despite there being no published trials showing that early detection reduces mortality, and separate evidence that it may not reduce mortality, many healthy men have been tested and have received treatment that can cause incontinence, impotence, and other complications.
While mammography and cervical smears have been shown to reduce cancer mortality and are to be strongly recommended, breast and testicular self examination are further examples of the failure to apply scientific rigour to screening, he says.
Self examination has been widely advocated on the assumption that it must be beneficial and cannot do harm. Yet in a recent large trial, breast self examination did not reduce mortality from breast cancer but caused more surgical biopsies and thereby more anxiety. This result should discourage prostate and testicular screening.
Giving information to people considering these unproven screening tests when the only honest information is complete uncertainty is useless, argues Law, while encouraging people to decide for themselves is ducking the issue.
For a new drug, a rigorous set of experimental data must be presented before it is licensed for use. The same rigour should apply to medical screening.
British Medical Journal (BMJ)
Self examination has been widely advocated on the assumption that it must be beneficial and cannot do harm. Yet in a recent large trial, breast self examination did not reduce mortality from breast cancer but caused more surgical biopsies and thereby more anxiety. This result should discourage prostate and testicular screening.
Giving information to people considering these unproven screening tests when the only honest information is complete uncertainty is useless, argues Law, while encouraging people to decide for themselves is ducking the issue.
For a new drug, a rigorous set of experimental data must be presented before it is licensed for use. The same rigour should apply to medical screening.
British Medical Journal (BMJ)
Cancer Current Events and Cancer News RSSMetabolic reactions: Less is more in single-celled organisms
A Northwestern University study has found a surprising similarity among four quite different organisms. The simplest organism, a bacterium called H. pylori, uses the same number of biochemical reactions (around 300) as yeast, the largest, most complex organism of the group, when optimizing growth.
Genetic breakdown in Fanconi anemia may have link to HPV-associated cancer
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Results of a phase III, international randomized clinical trial demonstrate a new standard of care for treating advanced ovarian cancer that significantly reduces side-effects and post-operative deaths compared to the previously established treatment course.
Researchers identify cell group key to Lyme disease arthritis
A research team led by the La Jolla Institute for Allergy & Immunology and Albany Medical College has illuminated the important role of natural killer (NK) T cells in Lyme disease, demonstrating that the once little understood white blood cells are central to clearing the bacterial infection and reducing the intensity and duration of arthritis associated with Lyme disease.
Researchers Discover New Enzyme in Cancer Growth
While studying the mechanics of blood clots, researchers at the University of Oklahoma Health Sciences Center discovered a new enzyme that not only affects the blood, but seems to play a primary role in how cancer tumors expand and spread throughout the body.
Angled gantry technique reduced breast radiation exposure by 50 percent
A novel angled gantry approach to coronary CT angiography reduced radiation exposure to the breast by more than 50%, according to Thomas Jefferson University researchers.
HER2 levels may aid in treatment selection for metastatic breast cancer
Findings published in the December 1, 2008, issue of Clinical Cancer Research, a journal of the American Association for Cancer Research, show lapatinib benefits women with HER2-positive breast cancer, while women with HER2-negative breast cancer or those who express EGRF alone derive no incremental benefit.
Drop in cancer deaths tied primarily to gains in behavior and screening
Improvements in behavior and screening have contributed greatly to the 13 percent decline in cancer mortality since 1990, with better cancer treatments playing a supporting role, according to new research from David Cutler of Harvard University.
Plants display 'molecular amnesia'
Plant researchers from McGill University and the University of California, Berkeley, have announced a major breakthrough in a developmental process called epigenetics. They have demonstrated for the first time the reversal of what is called epigenetic silencing in plants.
New breast imaging technology targets hard-to-detect cancers
Breast-specific gamma imaging (BSGI) is effective in the detection of cancers not found on mammograms or by clinical exam, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).
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