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How overdiagnosis and other harms can undermine the benefits of screening: A new primer in our toolkit

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Mary Chris Jaklevic is a reporter-editor at HealthNewsReview.org. She tweets as @mcjaklevic.

 

September marks National Prostate Health Month, when hospitals and urology practices push free prostate cancer screening.

It’s also when we at HealthNewsReview.org publish our annual analysis of why these promotions — and their “screening saves lives” message — are bad for men.

To help readers understand the issue more clearly, we’ve published an expanded toolkit primer that we hope gives consumers and journalists a solid base of knowledge about screening.

Our latest roundup on coercive prostate screening campaigns mentions enticements like game tickets and meet-and-greets with football pros.

But in fact, the misleading pitch that screening saves lives gets advanced year-round for a host of conditions such as breast cancer, head and neck cancer, skin cancer, heart disease, and lung cancer.

The slogan persists even as data mount on the harms of screening; as public health advocates blast community screening promotions as hurting consumers; and as patients increasingly are urged to make their own informed choices.

Screening involves testing people who don’t have symptoms of the disease, with the expectation that a few life-threatening cases will be detected early, and earlier will treatment will improve their outcomes. In other words, screening might save some people from dying of the disease.

But typically, vastly more people are harmed — by false alarms, unnecessary treatment, more testing, and invasive procedures — than are helped.

The physical, emotional, and financial harms of screening must be weighed against the potential benefit of saving a few lives, and it’s a numbers that game that is often tough to win.

So why do some providers continue to promote screening so eagerly? And what should we know that they aren’t they telling us?

A new primer

The new primer addresses these questions:

  • What is the evidence behind screening?
  • What are its harms?
  • What is overdiagnosis, and how does it impact patients?
  • What is lead time bias, and how does it distort our perception of screening?
  • Where can you go for more information?

You can find more tips for analyzing studies and health care claims in our TOOLKIT section.

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