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Is screening for cancer a giant con job?

Here's an article in the NYT about people who are diagnosed with cancer in midlife, and the trials they face after beating cancer. Many of them are impoverished, even driven into bankruptcy, by the high cost of their treatment and medications. Many of them survive cancer only to find out that doing so has made them unemployable. Employers, acting in their own rational self-interest, will not hire someone who hs had cancer, since they are afraid that person will drive up their health insurance costs. But hey, it's better than being dead, right? Now here comes the astounding part: "“Cancer used to be a disease that occurred after you retired, because that’s when you were diagnosed,” said Cathy J. Bradley, a health economist at Virginia Commonwealth University Massey Cancer Center who has studied employment among cancer patients. “Now patients are getting that diagnosis early on, which is a good thing. . . .But I don’t think they or their employers are prepared for the tradeoff, which is that someone may be out of work for a long time.” In other words: these people had their lives ruined by being diagnosed with "cancers" which, according to the article, never would have bothered them until they were at the end of their lives anyway! The word "cancer" is one of the most emotionally laden words in the English language, but when a pathologist uses the word "cancer," all she means is a tiny growth of abnormal-looking cells, which may or may not be harmful. There is no evidence that getting screened for cancer helps people to live longer. The whole idea of screening for cancer was based on the hope -- that's all it ever was, a hope -- that there were cancers that were so deadly that by the time symptoms appeared, it was too late to do anything about it, BUT, which if detected sooner by the new imaging technology, could be successfully treated. There is no evidence that such cancers even exist. What we do know is that, if they do exist, they must be so rare as not to make a difference in survival rates. What screening for cancer does do is detect the presence of tiny "cancers" which never would have harmed the patient. And, as the article makes clear, a diagnosis of cancer can ruin your life. So is screening for cancer a giant con job? Cancer Survivors Struggle to Find Jobs, Study Finds" by Roni Caryn Rabin http://www.nytimes.com/2009/02/18/health/18cancer.html?_r=1&ref=health Should I Be Tested for Cancer? Maybe Not and Here's Why by H. Gilbert Welch, MD, MPH http://www.amazon.com/Should-Be-Tested-Cancer-Maybe/dp/0520248368/ref=pd_bbs_1?ie=UTF8&s=books&qid=1234995311&sr=8-1 Worried Sick: a Prescription for Health in Overtreated America by Nortin M Hadler, MD http://www.amazon.com/Worried-Sick-Prescription-Overtreated-America/dp/0807831875/ref=sr_1_1?ie=UTF8&s=books&qid=1234995363&sr=1-1 A third-generation freethinker To PathologyGeek: You are kicking over a straw man. I never denied that cancers cause serious harm. What I said was that, according to Hadler and Welch, there are no controlled clinical trials which show that screening asymptomatic patients results in a clinically significant reduction in mortality. If you have any studies that do show this, I'd love to take a look at them. Your sneering, mean-spirited response shows what you're all about. I am glad I'm not your patient. To PathologyGeek: Your reply is an insult to anyone who has ever watched a loved one die of cancer (as I have). We already knew that cancer is a bad thing. That's not the issue here. The issue is whether screening asymptomatic patients saves any lives. Take screening for prostate cancer, for example. You know, the five-year survival rate for prostate cancer (survival rate after detection) is 90%. In the UK, it's 40%. That would seem to be a point in favor of our health-care system, until you realize that the death rate for prostate cancer is EXACTLY THE SAME in both countries. There are two possible interpretations for this: 1) People are being diagnosed earlier, but dying at the same time, in which case the screening is useless, and/or 2) People are being diagnosed and treated for "cancers" that never would have bothered them, in which case screening is worse than useless. Prostatectomy can leave a man impotent, incontinent, and/or both. To PathologyGeek continued: Am I to assume that's okay with you, as long as your profession gets it cut?

Public Comments

1. I think you are confused. The word "Tumor" refers to an abnormal growth of cells which could be benign or malignant. However, the word "Cancer" refers a malignant process. Simple screening for cancer will not help people live longer. But the active treatment of cancer helps people to live longer lives. For example, in the 1950's, 60's and 70's, a large number of women were suffering from endocervical carcinoma. With the increase of pap smears (a form of cancer screening), endocervical cancer has gone from one of the leading causes of cancers of cancer deaths affecting women to only 7,500 deaths per year (these women are known to have not undergone screening). This is because the early detection of cancer allows it to be treated before it is so invasive that it metastasizes to other organs (Virtually a death sentence) Retirement age is 65....you are considering your life over at 65? That is pretty sad. The average live expectancy for americans is 75-80 years old, and many live into their 90's. I work in a pathology laboratory and see cancer in human tissue on a daily basis. It is a real entity, and cancers DO cause serious harm and wreak havok on the human body. Cancer screening IS NOT a con job, but hey, if people like you want to refrain from testing, I'll consider that population control.
2. Yes, pretty much. There are a few cases in which it is helpful, like PSA screening and colonoscopy to find colorectal cancers. Also, checking your skin for suspicious lesions regularly, and self breast and testicular exams are free and somewhat effective ways to spot cancer early. Apart from that there is no evidence at all that aggressive screening causes people to live any longer, for many of the reasons cited in your question.
3. Just Plain Wrong, and Should Not Happen. EDIT: But to Address your Q, Often Yes, but Many people Think Screening Somehow Improves the Survival With Cancer.