Online CPR Certification Blog
Dissonance plagues cancer screening
Date: January 30th, 2014
Two sides of prostate cancer screening recommendations
Kenny Lin, who is a physician and was at the time with the said Task Force, said that for political reasons, the meeting ended up being cancelled and never took place. The physician directs us to a story published in the New York Times that highlights the dueling narratives pertaining the screening of prostate cancer. This topic has been discussed severally and it seems that there is an endless life to this topic. On one side, you will find the recommendations based on specialty that support PSA screening and are backed up by the emotional anecdotes of survivors of prostate cancer. On the other side are the recommendations based on evidence such as those from USPSTF. According to the Times, the camp makes an argument that is less emotionally satisfying. Scientific studies that exist do not support the fact that lives can be saved by screening healthy men. Ideally, screening can necessitate the need for additional testing and treatments which can injure the men and even cause death in the extreme cases.
General presentation of cancer screening
Generally, cancer screening is presented in positive light only in mainstream media. The most common thing is that early detection of cancer saves lives. However, the real reality is quite more nuanced and isn’t designed to pat inspirational ad campaigns or sound bites. This metaphor can be illustrated by a simple metaphor as highlighted here below as David Newman of Mount Sinai School of Medicine, Manhattan tells it.
‘Newman says that you imagine yourself as one of the 100 men waiting in the screening room. There are seventeen of you who are going to be diagnosed as suffering from prostate cancer in which three are destined that they will die from it. However, it isn’t known who they are. Now, imagine that a man with a white coat is waiting at the door with 17 pills in his hands and one is going to save one of the men having prostate cancer. Probably, you will want to invite them for the pill delivery in the room.
This is exactly how P.S.A testing effects are represented, in terms of only possible benefit. However, Newman says that for this P.S.A story to be conveyed completely, the metaphor must be extended. After handing the pills out, the man in white coat randomly shoots one of these seventeen men dead. He then shoots ten more men in the groin and leaves them incontinent or impotent. Newman asks, would you still consider opening the door? He notes that any treatment or screening test can only be measured accurately by examining the overall mortality. As such, researchers shouldn’t just look at the deaths resulting from the disease but at number of deaths the treatment causes as well. Cancer screening benefits must be presented exactly the same was as its benefits including the treatment complications and the risk of invasive testing.