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Overenthusiasm About Benefits of Cancer Screening?

Increasingly, the public is exposed to enthusiastic endorsements of cancer screening. In this national telephone survey of 500 adults without histories of cancer (men, 50 or older; women, 40 or older), investigators assessed the public's view of the value of cancer screening.

Among the participants, 99% of women reported having had Pap smears, and 89% reported having had mammograms; 71% of men had had prostate-specific antigen tests; and 46% of both men and women had undergone sigmoidoscopy or colonoscopy. These data closely match those found in larger national surveys. Eighty-seven percent of participants believed that routine screening is "almost always a good idea," 74% believed that finding cancer early saves lives most or all of the time, and two thirds would want to know they had cancer even if nothing could be done. Thirty-eight percent had experienced false-positive results; nearly half of these people called the experience "very scary" or "the scariest time of my life," but 98% were glad that they had undergone the original testing. Most respondents (86%) said they would get total-body computed tomography scans if they were available; among such people, 85% would prefer such scans to receiving US$1000 in cash.

Comment: The interpretation of these results depends on one's personal view of health and disease, but it is clear that public enthusiasm for cancer screening sometimes conflicts with clinical guidelines. Expanding technologies for cancer screening eventually might prove to be beneficial, but aggressive marketing of unproven technologies can lead to excessive expense and adverse clinical consequences. Patients seem to be less concerned about false-positive results than are many physicians.

— Thomas L. Schwenk, MD

Published in Journal Watch General Medicine February 10, 2004

Citation(s):

Schwartz LM et al. Enthusiasm for cancer screening in the United States. JAMA 2004 Jan 7; 291:71-8.

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