The trends in American society both among professionals (doctors) and the lay public are generally in favor of routine cancer screening, most commonly prostate specific antigen (PSA) testing for men and mammography for women, and colonoscopy/sigmoidoscopy for all. Thus, perhaps it should come as no surprise that, according to a new online poll conducted by the Max Planck Institute for Human Development in Berlin, physicians are not discussing with patients the risks of overdiagnosis or overtreatment all-too-often associated with these screenings. In fact, about 92 percent of the 317 men and women surveyed said they were not told about possible harms associated with these cancer screenings.
Researchers drew study participants between the ages of 50 and 69 from the U.S. panel of Survey Sampling International in 2010. Of the 8 percent of patients who were told about the risks of overdiagnosis/overtreatment, only one of those patients was given correct risk estimates. But, 8 out of 10 people surveyed said they wanted to know the risk and a third of patients who had not received screening but were informed of the risks, used this information to decide not to receive screening.
Dr. Neil H. Brooks, former president of the American Academy of Family Physicians highlights one of the key problems with this type of survey: recall bias. He says, A patient who is worried about cancer may indeed not remember details of an explanation about risks of a screening procedure because their focus is on obtaining the service, and the perceived risk of cancer far outweighs the intellectual argument about harms of treatment. He also adds that many doctors are themselves not aware of the specific degree of risks associated with screening and even if they are, they find it hard to communicate those risks to patients. Furthermore, the number one reason for lawsuits against primary care doctors is failure to diagnose cancer, and therefore physicians are often overly cautious. Potential solutions, according to Dr. Odette Wegwarth, will address these issues.
ACSH s Dr. Gilbert Ross adds, The implications of overdiagnosis and overtreatment which are bound to occur as a result of screening especially if screening is conducted promiscuously are extremely important to consider when deciding whether or not to undergo these tests. The fact that many doctors are unaware of the associated risks needs to be addressed in the medical community so that patients can make informed decisions about their healthcare.
