"The best test isn’t necessarily the one that finds the most cancer"

Do my eyes deceive me? A responsibly-written cancer screening article? From major media? Maybe there is hope after all. Needless to say, this is a must-read (emphasis mine):

. . . if you really want to find as much cancer as possible, we would suggest whole-body CT, MRI and PET scans every month. But that would be absurd. Why? Because the goal is not to find more cancer. The goal is to save lives. The two goals are not the same.

The problem is that cancers detected early may not be the ones that kill. It turns out there is a spectrum of cancers. Some rapidly kill, some progress more slowly and some do not progress at all (and may even regress). That is why some doctors recommend watchful waiting for men with early prostate cancer — because most men diagnosed with the disease will not die from it.

Cancer epidemiologists have a name for the detection of cancer in people who would otherwise never develop symptoms (or die) from the cancer. They call it over-diagnosis. Over-diagnosis is the reason that the number of people with cancer diagnoses is increasing much more quickly than the numbers dying from those cancers. This phenomenon is now recognized as occurring not only in prostate cancer but also in breast cancer, thyroid cancer and melanoma . . .

. . . Doctors and the public need to understand that finding more cancer is not the answer. You want to know whether a test saves lives or reduces the number of people with metastatic cancer. And you want to know about the downsides: how many people suffer needlessly in the process.

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