UMN Expert: Screenings are Best Tool We Have to Lower Cancer Deaths

									Charlie Plain |
																			June 26, 2015

According to the American Cancer Society, more than one million people in the United States get cancer each year. Furthermore, two in three people diagnosed with cancer survive at least five years, due in large part to early detection through cancer screening.

Photo Credit: Stephen Dickter/CC 2.0/
Photo Credit: Stephen Dickter/CC 2.0/

Cancer screenings are the best tool we have right now to lower the rates of death from cancer says Timothy Church, professor of environmental health sciences in the School of Public Health and a member of the Masonic Cancer Center, University of Minnesota. Church is also currently a member of the American Cancer Society’s Guideline Development Group.

“Detecting any disease earlier is beneficial when treatment can be administered more effectively at that point, but only if the harm done by screening is outweighed by the increased effectiveness of the treatment,” said Church. “By definition, screening tests are not diagnostic tests, so when a positive screening test indicates a person might have early disease, it is usually necessary to do more diagnostic testing to determine if the disease is really present.”

Some cancer screening programs may be more beneficial than others. Some screenings may, if a test comes back positive, require a more invasive, painful, and potentially costly diagnosis and treatment.

While this may sound a little worrisome, Church argues expanded tests are acceptable and warranted if the cancer found could be deadly. Still, there are some cases of over diagnosis, where the cancer is inactive and would not have harmed the patient had it never been discovered.

Church says over diagnosis is more prevalent in prostate cancers and some forms of breast cancers. In these instances, the patient is harmed by having their cancer detected. For example, a woman may have her breast removed and a man may end up impotent or incontinent and may have chronic pain or bleeding due to aggressive testing or treatments.

“We must do rigorous randomized trials to determine whether the net outcome of screening is beneficial or harmful before screening is recommended to the general public,” said Church.

So, who should get screened for cancer?

  • Currently, screening for colorectal, breast, and cervical cancer is widely recommended for average-risk individuals.
  • For heavy, older smokers (those over age 55 with at least 30 pack-years [years of smoking times number of packs/day] and fewer than 15 years of cessation), lung cancer screening with low-dose spiral CT (computed tomography) is recommended.

Church’s biggest takeaway is for men over 50 or those with a family history of cancer to discuss with their primary care provider which colorectal cancer screening method is best for them, and then to follow through on it. Those over 55 who have smoked a lot and as recently as 15 years ago should discuss low-dose CT screening with their provider as well. If people are concerned about their risk for prostate cancer due to family history of prostate cancer or are African-American, they should also discuss this issue with a physician and seek guidance.

During June’s men’s health month, make sure you know which cancer screening tests are recommended for you. Make an appointment with your primary care physician and discuss your options and medical history to help better understand your options.

~ Post written by Matt DePoint and originally published on Health Talk

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