Cancer Screening: The Downside of Vigilance

Breast, prostate cancer screenings may be counterproductive when not recommended

(RxWiki News) There's no doubt about it: preventative cancer screening can save lives. But new evidence suggests that some screenings may be inappropriate and even risky.

Nearly 16 percent of people age 65 or older with a life expectancy of less than 10 years have received non-recommended prostate or breast cancer screenings, a new study found. The authors of this study said unnecessary screenings can pose significant health risks to these patients, as well as accrue considerable healthcare costs.

For this study, Firas Abdollah, MD, of the Henry Ford Health System in Detroit, and team looked at data on patients age 65 or older who responded to the Behavioral Risk Factors Surveillance System survey in 2012.

Out of the 149,514 patients analyzed, 51.1 percent had received a prostate-specific antigen (PSA) test or a mammogram in the last year. Of those patients, 30.8 percent had a life expectancy of less than 10 years. That means 15.7 percent had a non-recommended screening.

The American Cancer Society (ACS) recommends women ages 40 to 44 have the option of annual breast cancer screening, and that women ages 45 to 54 get screened every year. Women age 55 or older should only receive screenings every two years, and those screenings should only continue if a woman is in good health and expected to live 10 years or longer, according to the ACS.

The ACS also recommends that women be made aware of the potential risks before screening, a piece of advice they also extend to men considering a PSA.

"Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment," the ACS states on their website. "We believe that men should not be tested without first learning about what we know and don’t know about the risks and possible benefits of testing and treatment."

What are the risks the ACS is referencing?

According to Boston University Medical Center, non-recommended screenings can result in "false positives," which can cause a patient much unneeded anxiety. They can also result in invasive, painful and sometimes expensive procedures that carry the risk of additional harm and even death.

This study also suggests that non-recommended screenings cost the US healthcare system an estimated $1.2 billion annually.

This study was published Jan. 21 in the journal JAMA Oncology.

No funding sources were disclosed. Dr. Abdollah was a consultant for GenomeDx Biosciences and Dr.Trinh was supported by Brigham and Women’s Hospital.

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Review Date: 
January 20, 2016