Thursday, November 24, 2011

Overtesting in North America

With all the research I have done, screening tests are, at best, iffy. Far better to self-examine, know your own body, and if you in a high-risk category, talk to your doctor. If you have symptoms it is a different story. But in these cases you want a more expensive, diagnostic test that is beyond screening. We don't know how many people have had mastectomies that were contra-indicated, and truly did not have cancer. It is a very individual process. Mammograms on those <50 are not effective due to less breast density. This is true, too, for PSA tests.

Without symptoms, these tests do not prove their merit.

The screening tests, without symptoms, have not shown any better results in mortality. For every 1000 - 1500 mammograms, they find one case of breast cancer. Many women are having radical surgeries without actual cancer. How many needless surgeries are taking up operating rooms when a life can be saved with required surgery?

The American system, where-by huge lawsuits are awarded, has resulted in a physician culture where overtesting, with inaccurate screening tests, means that physicians protect themselves.
In my 20 plus years of practice I have never seen such bewildering recommendations released as Canadian guidelines for breast cancer screening. It’s a serious watershed. Curbing costs have trumped saving lives.

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