Five things can result from screening tests & four are bad

Former Texas football coach Darrell Royal used to say “There are three things that can happen when you pass the ball and two of them are bad.”

Today in the New York Times, the chairman of the United States Preventive Services Task Force is quoted: “There are five things that can happen as a result of screening tests, and four of them are bad.”

Yet we continue to – if you’ll pardon my cross-analogies – pass the ball all the time.

Natasha Singer presents a very thoughtful roundup of perspectives challenging the conventional wisdom on screening tests in the Times today. Excerpt:

Nearly every body part susceptible to cancer now has an advocacy group, politician or athlete with a public awareness campaign to promote routine screening tests — even though it is well established that many of these exams offer little benefit for the general public.

An upshot of the decades-long war on cancer is the popular belief that healthy people should regularly examine their bodies or undergo screening because early detection saves lives. But in fact, except for a few types of cancer, routine screening has not been proven to reduce the death toll from cancer for people without specific symptoms or risk factors — like a breast lump or a family history of cancer — and could even lead to harm, many experts on health say.

Singer’s article raises questions about:

“Don’t forget to check your neck” thyroid cancer screening ad campaign.

Congresswoman Debbie Wasserman-Schultz’s early breast cancer screening bill.

The American Urological Association’s prostate cancer awareness campaign.

Mammograms (yes, mammograms).

Lung, ovarian, skin cancer screening.

For your own education, don’t miss my blog entry yesterday questioning what we know even about colorectal cancer screening. (see next entry below)

We need far more journalism like this.

Let me state again – because I can feel the rabid, crusading, pro-screening forces ready to fill my inbox: This is NOT an anti-screening test message. It is a call for evidence. And there shouldn’t be such such crusading pro-screening campaigns in the absence of evidence – or at least without a better public disclaimer about the lack of evidence.