Cancer Screening Tests

Medical professional groups and cancer advocacy groups need to refocus on educating rather than persuading about cancer testing. The harms of screening have been largely dismissed. It is easy to sell screening, just magnify the benefit, minimize the cost, and hide the data about their value.

These tests are big business and there are conflicts of interest that pressure manufacturers, doctors, big pharma, cancer advocacy groups to support doing many cancer screening tests over ambituously. The PSA test and mammogram on women under the age of 50 is no longer indicated as a routine in people without symptoms. Colonoscopies are also coming into question as the risks likely outweigh the benefits in asymptomatic people starting at age 50. GI bleeds requiring hospitalizations and perforations of the colon occur as often as important findings are discovered.

In a field plagued by frequent controversy, the American Cancer Society (ACS) claims to have taken a major step forward to provide transparency in how justified it is in recommending cancer screening tests. It blames oncologists with a conflict of interest...what would you expect from an organization that depends on income from big pharma and the mammography industry. They also plan to assess the need for the PSA test, colonoscopies, and mammograms. They suggest that overtesting leads to too many biopsies and over diagnosis.

Just a year ago, one of their senior physicians was interviewed by the NY Times and was quoted saying the same things as in the above. However, within 4 hours he was pressured into recanting his comments. Pressure from the ACS  was the reason for the "change of heart."

There is considerable confusion about the role of mammograms in breast cancer detection in premenopausal women. The US is the only country in the world making the recommendation that they be done on women under the age of 50. The people standing to profit from doing mammograms in this age group are the mammogram industry, Big Pharma in the sale of chemotherapy, and health care practitioners who treat people for cancer. Too many early cancers are found that do not progress and which do not kill are found and unnecessarily treated (DCIS). Recent data shows that it is necessary to do 1800 mammograms to save a single life. This would lead to far too many biopsies and treatment. The US is the only country in the world making the recommendation that they be done on women under the age of 50. The people standing to profit from doing mammograms in this age group are the mammogram industry, Big Pharma in the sale of chemotherapy, and health care practitioners who treat people for cancer. Too many early cancers are found that do not progress and which do not kill are found and unnecessarily treated (DCIS). Recent data shows that it is necessary to do 1800 mammograms to save a single life. This would lead to far too many biopsies and treatment.

Mammograms

The US Preventive Services Task Force (USPSTF) is a government organization whose function is to develop guidelines for health screening tests. Guidelines for cervical cancer have been developed and make a lot of sense. Women 21-65 should have a routine Pap smear every three years unless they also had an HPV screen at the same time; in that case every 5 years is sufficient. Women over 65 don't need either a Pap or HPV test if they have done routine exams and have been normal.

There is no need for HPV screening before age 30 because so many women have this infection and most of the time it clears on its own. Cervical cancer from HPV take decades to develop, so there is time to check for this after age 30 safely.

The inventor of the PSA test as come out and stated that the PSA era is over. We are over-diagnosing too many prostate cancers that don't need treatment with the test. There is no good prostate screening test today. The PSA test is good for following known prostate cancers as they are a good measurement of the extent of growth of the cancer.

Sniffer dogs can accurately identify people with lung cancer even through, smoker, copd, They can smell volatile organic chemicals (VOCs) that are breathed out by the lungs. It is safe, affordable, accurate, non-invasive, and may someday be used by MDs to screen for cancers. One day thorugh the use of spectrophotometry it is promising that chemicals specific only to cancer will be discovered that make the diagnosis of cancer far easier.

A study published in the October issue of the Journal of Thoracic Oncologyshowed that breath testing could be used to distinguish between lung nodules that were cancerous from those that were benign. Volatile organic compounds in the breath of people with lung cancer could be identified using gas chromatography with mass spectrometry. This is a much simpler, more accurate, and less dangerous way of diagnosing lung cancer. CT scans cost more, give cancer causing radiation, and have a 96% false positive result.

Previous studies on breast cancer using "sniffer" dogs have shown this many years ago. It is not a surprise that there are specific volatile chemicals in the breath of people with lung cancer considering the complexity of how the body's physiology works. This new test may be extremely useful in the next few years.