American Cancer Society Rethinking Recommendations On Screening

A report in today's New York Times says that the society is now at work on a new message that advises patients of the risks as well as the benefits of screening for prostate and breast cancer. The message is slated to be posted on the ACS Web site in the spring.

Researchers at the University of California at San Francisco and the University of Texas Health Sciences Center have found that while screenings for breast cancer have produced a 40 percent increase in cancer diagnoses and a near doubling of early-stage cancers, but only a 10 percent decline in cancers that have spread beyond the breast. Surgery professor Laura Esserman of UCSF and urology profesor Ian Thompson of Texas also reported similar figures for prostate cancer screenings.

The researchers point out in their JAMA article that if the screenings were truly effective at detecting potentially dangerous tumors, the rise in early-stage diagnoses would be offset by a drop in late-stage tumors that have spread. Instead, the researchers found that screenings also pick up tumors that could be ignored because they would not spread or even be noticed if left alone.

This raises the probability that breast and prostate cancer screenings actually overdiagnose cancers, making the response to these findings politically tricky.

The American Cancer Society does not want to recommend that patients stop getting screened, but it does want to advise patients about the risks involved. Doctors, meanwhile, are left with the equally difficult task of determining whether a tumor detected in a screening is harmless or dangerous.

Written by Sandy Smith