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Interesting Statistic - Cancer Screening

Discussion in 'The Okie Corral' started by AA#5, Mar 31, 2012.

  1. AA#5

    AA#5

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    Do physicians understand cancer screening statistics? A national survey of primary care physicians in the United States by Odette Wegworth, published in the March 6, 2012 issue of the Annuals of Internal Medicine, found, “Most primary care physicians mistakenly interpreted improved survival and increased detection with screening as evidence that screening saves lives. Few correctly recognized that only reduced mortality in a randomized trial constitutes evidence of the benefit of screening.” Primary care physicians were more enthusiastic about the screening test supported by irrelevant evidence (5-year survival increased from 68% to 99%) than about the test supported by relevant evidence (cancer mortality reduced from 2 to 1.6 in 1000 persons). (Screening is performed by early detection tests, like mammograms to find breast cancer and PSA tests for prostate cancer.​

    Comments: Survival statistics are susceptible to lead-time and over-diagnosis biases. While your doctor should know this basic information, most don’t; and you and your family will pay dearly for his or her ignorance.
    Lead-time bias occurs when disease is found earlier, but the day of death remains the same. For example, if a person is destined to die in June of 2017 of cancer, and the cancer is found in June of 2016, then the person would have lived for only a year knowing about the cancer. However, if aggressive testing is used and by “earlier detection,” the cancer is found in June of 2012, then the person lived much longer aware of the cancer (for five years), but he/she still dies the same day. If cure is defined as “living for five years,” then, in this example, the person was cured by early detection, but still died the same day.

    The entire newsletter from this doctor (John McDougall) can be found here:
    http://www.drmcdougall.com/misc/2012nl/mar/120300.htm
    (Click on March 2012 & click on MORE & scroll down to doctors, mammograms, PSA testing)​

    Any MD's here care to comment?​
     
    Last edited: Mar 31, 2012
  2. goldenlight

    goldenlight

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    Cancer screening, cancer drugs, and ESPECIALLY treating cancer is VERY profitable for the USA medical industry.

    Because, it's ALWAYS about the money, after all; ALWAYS.:steamed::steamed::steamed:
     

  3. jbotstein1

    jbotstein1

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    Stupid doctors...

    We are taught, and most docs should know, about lead time bias. Are you posting this to argue that screening tests are stupid? Yes, lead time bias exists and is real, but do you know how many people have cancers and other illnesses found during a screening, and how many of those people go on to be treated and cured because of early diagnosis? Lead time bias is a statistical finding. I doubt you'd be able to convince the millions of people who have been saved by being detected by a screening test. Try and tell them that they will pay for their doctors ignorance.

    Lead time bias only matters for a disease for which we have no cure or treatment. I'll ask you, would you rather find out about your very treatable colon cancer now or in 5 years when you are pooping blood and it has metastisized to your liver and lungs?
     
  4. jbotstein1

    jbotstein1

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    And a 5 year survival rate is merely a measure of the lethality of a disease or the efficacy of a treatment. How would we know if we were actually making a difference without these statistics?

    A screening test by definition should only be implemented if early detection of the disease will be beneficial to the patient. That is why PSA screening is controversial. We don't know if a person who has a PSA of 5 has cancer or not, just that they have a PSA of5 which is considered high, but may actually be their baseline.
     
  5. Shagrat

    Shagrat

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    Especially profitable for the American Cancer Society. In 2008 for every $1 spent on research etc, $6.40 was spent on salaries, overhead, hotel stays and perks.
     
  6. AA#5

    AA#5

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    I posted this because I found it very interesting & I had never heard of "Lead Time Bias." I started to suspect that it existed (without knowing what it was called) many years ago when a couple of friends were diagnosed with different types of cancers & their doctors told them the typical line, "You're lucky you came to me with this so early when we can cure it....many people just wait, then it spreads, and the survival rate is much lower."

    Both died within six months.

    It seems to me that early detection doesn't have nearly as much an impact on the outcome as the aggressiveness of the cancer. As the article stated, early detection means more time knowing & worrying, rather than a better chance of successful treatment.

    They are already admitting now that PSA tests don't tell us anything useful & they often lead to dangerous & more invasive tests & treatments for something that will never harm us if left alone.
     
  7. Z71bill

    Z71bill

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    So - Just say no to the colonoscopy?
     
  8. Mrs. VR

    Mrs. VR Sharon, you will be missed.

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    I will disagree. My mom has a very rare, very aggressive ovarian cancer that was found by a total fluke when she went in for hernia surgery. only study shows a four year survival rate which we are just approaching with (knock on every piece of wood around) NO RETURN. Of course that's anecdotal, and of course there is a lead time bias, but does that mean screenings are a bad idea?

    Both my parents have had melanomas that were caught by regular skin surveys early enough to get them all out.

    So many kinds of cancer are treatable when caught early, why on earth would anyone want to discourage screenings? The only reason I can think of is that they cost money, and then WHO is putting money above health?
     
  9. certifiedfunds

    certifiedfunds Tewwowist

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    Beware of self promoting doctors who want to make themselves look uber smart and insightful by insinuating that all other doctors are dumb or corrupt.
     
  10. vikingsoftpaw

    vikingsoftpaw DEPLORABLE ME!

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    Yea. I read a lot of the comments in the local paper online. They hate Big Pharma and say 4-20 is the cure for most illnesses. They hate Big Pharma but like Big Contraception.
     
  11. 2bgop

    2bgop

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    Well that does it. No more tests for me, I am rolling the dice baby! Big medicine will not make a dime off me.
     
  12. Flying-Dutchman

    Flying-Dutchman

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    Actually there is some debate as to the overuse of colonoscopies as opposed to testing for blood which is almost as effective.

    Colonoscopies carry some risk although if you are genetically prone to that sort of cancer early detection is a real life saver.

    The standard is to test everyone over age 50, yet if you have good digestion and no family history is this test effective in lowering death rates?
     
  13. AA#5

    AA#5

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    I am just as wary of doctors who think they have all the answers.
     
  14. AA#5

    AA#5

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    As with all of them - American Heart Association, etc.

    I had a little fun with the American Cancer Society a few months ago. On their website, they have a list of ways to avoid cancer. One of them says to "Avoid processed meats - specifically hot dogs." I was running an errand at Walgreen's Pharmacy & in their parking lot was a huge banner that read, "American Cancer Society....Buy a $1.00 Raffle Ticket & Get a Free Hot dog." Two men were sitting at a table selling raffle tickets & keeping the grill full.

    I e-mailed them & asked them why they would encourage people to eat foods they say cause cancer just to raise funds. I also asked them if they are part of the solution or part of the problem. They told me they didn't know they were raising funds that way & thanked me & said they would "watch their activities more closely."
     
  15. AA#5

    AA#5

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    I've heard the usual line, "When we find polyps, we can cut them out right away before they turn cancerous."

    Then, I read that most people over 50 have developed polyps in their colon - doesn't mean they're going to become cancerous. And most men over 50 have an enlarged prostate. Both are part of the aging process. If so, I'm not convinced that aging is a disease that should be treated.

    When you think of all the other places cancer can occur, wouldn't we be safer if we were tested weekly in our lungs, bladder, pancreas, stomach, kidneys, esophagus, brain?

    Did I miss any? :supergrin:
     
  16. smokeross

    smokeross GTDS Member #49

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    My PSA never got above 2.3 except when I had a prostate infection. But it went up quickly when it did go to 2.3 My doctor recommended a biopsy due to family history. Came back positive. I got the latest and greatest surgery. Pathology results came back saying the cancer was very aggressive. I'm glad it's gone. PSA tests since are undetectable. Screening, early detection, and surgery most likely saved my life.
     
  17. certifiedfunds

    certifiedfunds Tewwowist

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    http://www.cap.org/apps/docs/reference/myBiopsy/hyperplastic_colon_polyps.html
     
  18. certifiedfunds

    certifiedfunds Tewwowist

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    Then just abstain.

    Seriously.

    Don't get screened or treated for cancer. Problem solved.
     
  19. AA#5

    AA#5

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    Thanks. Interesting & useful info from that link (nice to be reassured I'm doing the right thing):

    "Polyps also are associated with a diet high in fat and beef and low in fiber."

    "You can lower the chances of developing polyps by adopting a healthy diet and lifestyle. Fruits, vegetables and whole grain—especially those with high fiber content—are recommended."
     
  20. certifiedfunds

    certifiedfunds Tewwowist

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    Hopefully it also shed some light on why the excise them.
     
    Last edited: Apr 1, 2012