Routine screenings for cancers -- including breast cancer in younger women -- have not proven to reduce the chance of death for people without specific symptoms or risk factors, and experts suggest that some tests could lead to harm, the New York Times reports.
According to Ned Calonge, chair of the United States Preventive Services Task Force, screening is only useful if it prevents enough deaths to outweigh harm from treatments that are not medically necessary. He said that although screening in some cases will detect life-threatening cancers that respond to intervention, it also can result in false positives that cause needless worry and unnecessary procedures. Screening also might fail to diagnose an existing cancer, causing patients to ignore symptoms; find slow-growing or stable cancers that are not life-threatening and normally do not need treatment; or find aggressive, life-threatening cancers that do not respond to treatment, Calonge said. Only a handful of screening tests have been proven to significantly reduce death among certain age groups: pap tests to screen for cervical cancer beginning no later than age 21; mammograms to screen for breast cancer starting at age 40; and colon cancer screening beginning at age 50. According to the Centers for Disease Control and Prevention, there is no medical proof that routine screening for many other cancers -- including ovarian cancer -- reduces deaths.
The Times reports that the Breast Cancer Education and Awareness Requires Learning Young Act of 2009 (HR 1740) -- also known as the Early Act -- has become a central issue in the debate because it would create a breast cancer detection campaign for women younger than age 45. Rep. Debbie Wasserman-Schultz (D-Fla.) introduced the bill in March, and it now has more than 350 co-sponsors. The bill would provide $45 million over five years for teaching young women and their physicians to check for abnormalities; promote healthy lifestyle choices; and provide grants to groups supporting women with breast cancer. The bill focuses on certain ethnic or racial groups at higher risk of developing aggressive tumors. CDC would oversee an expert panel to create the campaign based on the latest medical research, Wasserman-Schultz said.
Critics of the bill say that the legislation promotes techniques, such as self-exams, that have not proven to detect cancer at earlier stages or reduce deaths. They also argue that self-exams could lead to many insignificant nodules being biopsied, which can cause scarring and make it harder to detect breast cancer when women are older. According to Susan Love -- a breast cancer surgeon who has encouraged Wasserman-Schultz to abandon the bill -- the public health campaign could cause younger women to overestimate their chances of dying of breast cancer (Singer, New York Times, 7/17).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
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