Screening Tests Screened Out
It's been a bad month for the lucrative health-screening-test industry. First, the United States Preventative Services Task Force said men should just say no to PSA tests for prostate screening.1 That recommendation came on the heels of a US study that found that men who were screened regularly actually had a higher death rate from prostate cancer than those who didn't have the test at all.
Next, the Task Force suggested that the golden standard of annual PAP testing for women does more harm than good given the error rate of up to 60 percent.2 That includes false positives that could lead to harmful procedures and tests, as well as results that completely miss existing cancers, which happens 20-45 percent of the time. The Council suggested reducing the PAP testing schedule to once every three years.3
Then, a National Cancer Institute study concluded that women should not have annual mammograms after all, given that they, too, have a 60 percent error rate.4 The study suggests that every other year should be quite enough, as that would lower the error rate to a mere 42 percent.
And now, the National Cancer Institute says that chest X-rays do absolutely nothing to prevent lung cancer deaths and should not be performed on apparently healthy patients at all.5 This recommendation comes following a 13-year-study of over 150,000 people, some of whom received four chest X-ray screenings annually. Those who got the screenings actually died at a greater rate from lung cancer than did those who never got screened at all, whether or not they smoked -- hardly a surprise, considering that X-rays are a known cause of cancer.6 And even though the Task Force came to the same conclusion back in 2004, doctors continue to "prescribe" chest X-rays to this day, particularly for smokers. As Robert Smith, director of cancer screening at the American Cancer Society says, "No one recommends it but they do occur quite a lot."
Still, the experts do agree that X-rays may be useful for those who already display symptoms of what could be lung-cancer. Sort of an "in for a penny, in for a pound kind of thing." And given that lung cancer is the leading cause of cancer death in the US, the scientists haven't given up the idea that regular screening for the disease is a good idea. Unfortunately, though, at the top of the list of alternatives is CT scanning to replace the X-rays. A study comparing the efficacy of X-rays versus CT scans found that CT scans did, in fact, lower the death rate from lung cancer by 20 percent, but that study only looked at heavy smokers. And, the false-positive rate for CT scans is off the charts at 95 percent. Given the psychological damage that having a false lung-cancer diagnosis can cause as well as the potential exposure to unneeded treatments and the fact that CT scans emit enough radiation to fry the family cat, it hardly seems worth it except in cases when there's already reason to suspect something is seriously wrong.
The upshot is that those of us who have been poked, prodded, scraped, and radiated to get our annual tests may be somewhat dismayed to discover that all the money and time spent may have been for naught -- or to be kind, very little. Given the newly discovered lack of benefit from some of the tests combined with the side effects of all those X-rays and the psychological fallout resulting from false positives, you might think twice about doing just what the doctor orders to ensure your health. In fact, after years of hearing that we absolutely must get all these tests or our demise is imminent, it's difficult to take seriously the admonitions to take other preventative steps, like getting the annual flu shot or giving our 11-year-olds HPV vaccines. Certainly the recent announcement by the Centers for Disease Control that the flu shot this year is only 59 percent effective doesn't inspire confidence, especially considering that coming from the CDC that's likely to be a highly optimistic estimate. But that shouldn't come as a surprise because the shot hasn't been particularly effective for years now, as Jon Barron has written before. He's also written about the potentially ugly side effects. And still, the experts insist we should take the shot anyway, effective or not, side effects be damned.
So once again, the conclusion is obvious. Your safest bet is to stay healthy by following a healthy lifestyle. At the least, if you eat right and detox regularly, you'll have a strong immune system to deal with the side effects these tests and vaccines inflict upon you --should you decide to get them.
1 Sampson, David. "US Panel Says ‘No' to PSA Screening." 7 October 2011. ACS Pressroom Blog. 27 October 2011. < http://acspressroom.wordpress.com/2011/10/07/u-s-panel-says-no-to-psa-screening/>
2 Slowik, Guy, MD. "How Accurate are PAP Smear Results?" 28 June 2011. eHealthMD. < http://ehealthmd.com/content/how-accurate-are-pap-smear-results>
3 Jaslow, Ryan. "Cervical cancer screenings every year a bad idea, panel suggests." 20 October 2011. HealthPop. < http://www.cbsnews.com/8301-504763_162-20123105-10391704.html?tag=contentMain;contentBody>
4 Associated Press. "New Study: Mammograms every other year, not annually. 17 October 2011. Grand Forks Herald.com. 27 October 2011. < http://www.grandforksherald.com/event/article/id/218644/>
5 Winslow, Ron. "X-Rays No Help Against Lung Cancer." 27 October 2011. The Wall Street Journal. 27 October 2011. <http://online.wsj.com/article/SB10001424052970204505304576655200998360580.html?mod=googlenews_wsj>
6 Committee to Assess the Health Risks from Exposure to Low Levels of Ionizing Radiation. "Beir VII: Health Risks from Exposure to Low Levels of Ionizing Radiation." 2005. National Academies. Accessed 27 Oct 2011. <http://dels-old.nas.edu/dels/rpt_briefs/beir_vii_final.pdf>