Why cancer screening has never been shown to “save lives”—and what we can do about it.
Prasad V, Lenzer J, Newman DH. BMJ. 2016-01-06 23:00:51, 2016;352.
Written with widely respected cancer doctor and methodologist, Vinay Prasad, this article reviews the failure of many cancer screening tests to “save lives” – in part because overdiagnosis and false positive results lead to harms that offset any benefits of screening.
Despite growing appreciation of the harms of cancer screening, advocates still claim that it “saves lives.”This assertion rests, however, on reductions in disease specific mortality rather than overall mortality.
Using disease specific mortality as a proxy for overall mortality deprives people of information about their chief concern: reducing their risk of dying. Although some people may have personal reasons for wanting to avoid a specific diagnosis, the burden falls on providers to provide clear information about both disease specific and overall mortality and to ensure that the overall goal of healthcare—to improve quantity and quality of life—is not undermined.