Reevaluating the Efficacy of Cancer Screenings: Not All Tests Extend Life
A new meta-analysis pooling results from 18 randomized clinical trials and more than 2.1 million people challenges the conventional wisdom around cancer screenings as a life-extending preventative measure. The findings indicate that most commonly used cancer screenings, except for sigmoidoscopy, do not significantly extend life expectancy.
HCN Medical Memo
These findings emphasize the need for a nuanced approach to recommending cancer screenings. Although screenings can be beneficial in some cases, the onus is on healthcare providers to offer full transparency about the potential risks involved. Importantly, this study supports the importance of personalized, evidence-based discussions with patients to determine the appropriateness of specific screenings.
- The study was published in the Journal of the American Medical Association (JAMA) Internal Medicine and includes nine years of follow-up data.
- Among the tests examined (breast, lung, prostate, and colon cancer screenings), only sigmoidoscopy showed a significant life expectancy gain of 110 days.
- Although there was a modest life expectancy extension of 37 days for prostate cancer screening and 107 days for lung cancer screening, these estimates are uncertain.
- The authors of the study emphasized that they are not against cancer screenings; instead, they advocate for transparency and open discussions between physicians and patients about potential risks and benefits.
- Risks associated with screenings include colon tearing from colonoscopies and heart attacks from invasive prostatectomies.
- A 2022 study revealed that several cancer screening guidelines fail to capture the potential harms adequately.
- Benefits of screenings, as outlined in previous studies, include the potential for substantial reductions in mortality rates for specific types of cancer.
- According to the American Cancer Society, approximately 2 million people in the US will be diagnosed with cancer in 2023, with breast and prostate cancers being the most common diagnoses.
“If there’s overwhelming evidence of a net benefit of a screening test, we don’t want to scare somebody off [from getting screened]. But by the same token, if there’s a risk that [a serious harm] could happen if you have a screening test or a follow-up diagnostic test, then it’s a physician’s obligation to inform patients about what the risks of those procedures are.”
– Paul Doria-Rose, Study Author and Chief of the NCI Healthcare Assessment Research Branch
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