reddevil
23-10-06, 15:43
Worried sick
By Brendan O'Neill
Awareness of breast cancer is high due to numerous campaigns
Medical experts and charities urge us to be more "aware" of cancer, but the trend for self-examination is causing anxiety and leading to needless operations. So can a little too much knowledge of the disease be a dangerous thing?
It seems commonsensical that the more we know about the symptoms of various cancers, the more effectively we might spot warning signs in ourselves and visit a doctor for potentially life-saving treatment.
Women of all ages are encouraged to examine their breasts regularly for lumps, bumps and other abnormalities and those over 50 are advised to have a yearly mammogram - an X-ray of the breasts that shows up abnormal growths.
Men, especially those aged 15 to 35, are encouraged to carry out monthly testicular self-examination (TSE), looking for symptoms of testicular cancer. It is the most common form of cancer in young men, with around 2,000 cases a year.
Celebrity-backed advertising campaigns, posters in GPs' waiting rooms and even a range of T-shirts in Topman encourage young men to "check themselves" regularly.
Yet some medical researchers and cancer experts are now casting doubt on the benefits of these seemingly commonsensical tests.
Studies over the past few years have concluded that both self-examination and mass screening for signs of cancer can sometimes cause a good deal of harm - as well as good - generating widespread anxiety, giving rise to misdiagnosis and even leading to unnecessary and invasive surgical procedures.
Screening for breast cancer has been called into question, by some
Could it be that too much awareness about cancer is potentially a bad thing?
"What seems like good and obvious advice in everyday life is not always scientifically or medically sound", says Peter Gotzsche, MD, director of the respected Nordic Cochrane Centre in Copenhagen.
Last week, Mr Gotzsche caused something of an international storm with his latest report on the benefits and harms of mammography screening.
His team of researchers examined international studies of more than half a million women, and found that for every 2,000 women screened for breast cancer over a decade, one will have her life prolonged but 10 will undergo unnecessary treatment.
"So we might say there is a benefit of one but a harm of 10 from screening for breast cancer", says Mr Gotzsche.
Around a fifth of cancers picked up by screening are in the milk ducts of the breast, and sometimes these cancers do not progress to become life-threatening.
The Cochrane study found that, following screening, 10 in 2,000 women were having invasive and sometimes sickness-inducing procedures - including chemotherapy, radiotherapy or mastectomies - for cancers that may never have developed. The word "may" is, of course, crucial - women who underwent treatment may never know whether they might have escaped cancer or not.
It also found that mass screening can lead to misdiagnosis. Two-hundred women out of every 2,000 experienced high levels of distress or anxiety as a result of "false positives" - results which suggest that cancer is present but which later turn out to be wrong.
This study follows the Cochrane Centre's report into breast self-examination, published in 2003.
Based on 388,535 women from Russia and Shanghai, the earlier report compared the experiences of those who regularly self-examined with those who did not.
It found there was "no statistically significant difference in breast cancer mortality" between those who examined themselves and those who didn't - that is, there was little evidence that self-examiners lived longer in the event of finding breast cancer and having it treated.
And it found that unnecessary interventions - biopsies which later turned out to be benign - were twice as common among the self-examining group.
Men... self-examination... you get the picture
This led some countries to register breast self-examination as "potentially harmful" and to discourage women from pra
By Brendan O'Neill
Awareness of breast cancer is high due to numerous campaigns
Medical experts and charities urge us to be more "aware" of cancer, but the trend for self-examination is causing anxiety and leading to needless operations. So can a little too much knowledge of the disease be a dangerous thing?
It seems commonsensical that the more we know about the symptoms of various cancers, the more effectively we might spot warning signs in ourselves and visit a doctor for potentially life-saving treatment.
Women of all ages are encouraged to examine their breasts regularly for lumps, bumps and other abnormalities and those over 50 are advised to have a yearly mammogram - an X-ray of the breasts that shows up abnormal growths.
Men, especially those aged 15 to 35, are encouraged to carry out monthly testicular self-examination (TSE), looking for symptoms of testicular cancer. It is the most common form of cancer in young men, with around 2,000 cases a year.
Celebrity-backed advertising campaigns, posters in GPs' waiting rooms and even a range of T-shirts in Topman encourage young men to "check themselves" regularly.
Yet some medical researchers and cancer experts are now casting doubt on the benefits of these seemingly commonsensical tests.
Studies over the past few years have concluded that both self-examination and mass screening for signs of cancer can sometimes cause a good deal of harm - as well as good - generating widespread anxiety, giving rise to misdiagnosis and even leading to unnecessary and invasive surgical procedures.
Screening for breast cancer has been called into question, by some
Could it be that too much awareness about cancer is potentially a bad thing?
"What seems like good and obvious advice in everyday life is not always scientifically or medically sound", says Peter Gotzsche, MD, director of the respected Nordic Cochrane Centre in Copenhagen.
Last week, Mr Gotzsche caused something of an international storm with his latest report on the benefits and harms of mammography screening.
His team of researchers examined international studies of more than half a million women, and found that for every 2,000 women screened for breast cancer over a decade, one will have her life prolonged but 10 will undergo unnecessary treatment.
"So we might say there is a benefit of one but a harm of 10 from screening for breast cancer", says Mr Gotzsche.
Around a fifth of cancers picked up by screening are in the milk ducts of the breast, and sometimes these cancers do not progress to become life-threatening.
The Cochrane study found that, following screening, 10 in 2,000 women were having invasive and sometimes sickness-inducing procedures - including chemotherapy, radiotherapy or mastectomies - for cancers that may never have developed. The word "may" is, of course, crucial - women who underwent treatment may never know whether they might have escaped cancer or not.
It also found that mass screening can lead to misdiagnosis. Two-hundred women out of every 2,000 experienced high levels of distress or anxiety as a result of "false positives" - results which suggest that cancer is present but which later turn out to be wrong.
This study follows the Cochrane Centre's report into breast self-examination, published in 2003.
Based on 388,535 women from Russia and Shanghai, the earlier report compared the experiences of those who regularly self-examined with those who did not.
It found there was "no statistically significant difference in breast cancer mortality" between those who examined themselves and those who didn't - that is, there was little evidence that self-examiners lived longer in the event of finding breast cancer and having it treated.
And it found that unnecessary interventions - biopsies which later turned out to be benign - were twice as common among the self-examining group.
Men... self-examination... you get the picture
This led some countries to register breast self-examination as "potentially harmful" and to discourage women from pra