Some publications love lists.
Prevention magazine is one such publication.
The March issue is out and the first big story is “4 Screening Tests Women Fear.”
The problem is: only 2 of the 4 tests discussed are screening tests.
Yes, mammograms and colonoscopies are screening tests – used in an apparently healthy population looking for signs of trouble.
Endoscopies and MRI scans – as discussed by Prevention in this case – are not screening tests but diagnostic tests used to help diagnose what is the problem in people with signs or symptoms of something wrong. Screening tests are for people believed to be healthy. Diagnostic tests are for people believed to have a problem.
Prevention even writes: “Endoscopy is used to investigate the cause of specific symptoms.” That’s not screening.
They write about MRI: “Doctors use MRI to help diagnose everything from torn ligaments to brain tumors and cancer.” Diagnose, not screen.
The semantics are important. Lumping diagnostic tests like endoscopy and MRI in with screening tests like mammograms and colonoscopies can give readers the impression that everyone should consider all of them. And, no, not everyone needs to be worried about when to have their next endoscopy or MRI scan (even though the trendlines in our medical arms race would steer more and more of us toward these tests for some reason or another, justified or not.)
And even when the feature did discuss screening tests, its information was incomplete.
It cites a Swedish study that “found that regular mammograms can cut the death rate of women in their 40s by up to 29%.” I suggest that Prevention’s editors read my blog post, “This is the way the Swedish mammography study could/should have been analyzed.”
As alternatives to colonoscopy, Prevention mentions virtual colonoscopy and virtually predicts FDA approval (as soon as 2012) for a DNA stool test. There was no mention of the fact that the U.S. Preventive Services concludes that the evidence is insufficient to assess the benefits and harms of either approach.
This “news you can use” light, fluffy feature list of “screening tests women fear” should ratchet up the right information and ratchet down the fear – for the sake of public health.