Cancer remains the number one cause of disease and death in Australia. The government now invests in 3 cancer screening programmes for Cervical Cancer , Breast Cancer and Bowel Cancer .
Screening Tests are not diagnostic tests ,rather they are designed to detect populations which are at higher risk of having cancer , who would benefit from further diagnostic (definite ) tests. If you have symptoms like a breast lump , rectal bleeding , weight loss, fatigue …, than you should talk to your doctor and not have a screening test.
Screening tests should be acceptable by the wider population , easily repeatable should not falsely under diagnose cancers , but also not falsely over diagnose cancers, an effective treatment for condition should be available.
While there is no doubt that screening for above conditions saves lives , this might come at a price and some media and government hype should better be avoided.
For 2000 women screened over 10 years for breast cancer 1 life is saved , 10 women are unnecessarily treated , 200 women receive alarming false positive results and need further tests. Cervical Cancer screening (2 yearly PAP smears) have reduced cervix cancer deaths from 4/100000 women in 1991 to 1.9 deaths per 100000 women in 2008. Prostate cancer screening currently requires 48 men to be unnecessarily treated for one life to be saved. Unnecessary treatment is emotionally and physically traumatic can lead to pain , infection impotence or even death.
Bowel cancer screening might work but had a difficult start so far in that 400000 faulty screening tests have been sent out since it was rolled out earlier this year , which now have to be recalled , new ones be sent out , which surely will cause a lot of grief in the affected. The decision to undergo cancer screening or not should not be taken lightly , screening works but comes with a price tag. Your decision should be informed , which you can achieve by discussing pro’s and cons with your doctor, or the use of decision aids explaining the outcomes of screening. Medicine and Screening cannot provide 100% guarantees. Patients and Doctors are put in a difficult position especially as government bodies push for pay of doctors being linked to performance percentages. The linking of population screening rates to practice pay could make doctors biased in their provision of pre screening information and push patients to screening , who if informed might not go for it and consequently suffer unnecessarily.
Cancer Screening Decision Aids:
http://bowelcancerscreening.csiro.au
www.cancerscreeningdecision.org ( bowel)
www.mammogram.med.usyd.edu.au
Helko Schenk
16 11 2009
Sources:
- Australian Doctor 6 11 2009
- Australian Family Physician 4 2009
Screening Tests are not diagnostic tests ,rather they are designed to detect populations which are at higher risk of having cancer , who would benefit from further diagnostic (definite ) tests. If you have symptoms like a breast lump , rectal bleeding , weight loss, fatigue …, than you should talk to your doctor and not have a screening test.
Screening tests should be acceptable by the wider population , easily repeatable should not falsely under diagnose cancers , but also not falsely over diagnose cancers, an effective treatment for condition should be available.
While there is no doubt that screening for above conditions saves lives , this might come at a price and some media and government hype should better be avoided.
For 2000 women screened over 10 years for breast cancer 1 life is saved , 10 women are unnecessarily treated , 200 women receive alarming false positive results and need further tests. Cervical Cancer screening (2 yearly PAP smears) have reduced cervix cancer deaths from 4/100000 women in 1991 to 1.9 deaths per 100000 women in 2008. Prostate cancer screening currently requires 48 men to be unnecessarily treated for one life to be saved. Unnecessary treatment is emotionally and physically traumatic can lead to pain , infection impotence or even death.
Bowel cancer screening might work but had a difficult start so far in that 400000 faulty screening tests have been sent out since it was rolled out earlier this year , which now have to be recalled , new ones be sent out , which surely will cause a lot of grief in the affected. The decision to undergo cancer screening or not should not be taken lightly , screening works but comes with a price tag. Your decision should be informed , which you can achieve by discussing pro’s and cons with your doctor, or the use of decision aids explaining the outcomes of screening. Medicine and Screening cannot provide 100% guarantees. Patients and Doctors are put in a difficult position especially as government bodies push for pay of doctors being linked to performance percentages. The linking of population screening rates to practice pay could make doctors biased in their provision of pre screening information and push patients to screening , who if informed might not go for it and consequently suffer unnecessarily.
Cancer Screening Decision Aids:
http://bowelcancerscreening.csiro.au
www.cancerscreeningdecision.org ( bowel)
www.mammogram.med.usyd.edu.au
Helko Schenk
16 11 2009
Sources:
- Australian Doctor 6 11 2009
- Australian Family Physician 4 2009
