Good piece on the side and distorting effects of some cancer awareness campaigns. Worth reflecting upon, but some of this reflects our desire to help others, our sometimes shallow culture, and our belief that we can control things. Quote:
Yet I wonder if breast cancer really needs any extra attention when a few years ago the release of painstakingly crafted recommendations to individualize mammography decisions for women in their 40s caused weeks of public furor and threatened to derail health reform legislation over the make-believe issue of “rationing.” And from a public health standpoint, focusing on this single cancer to the exclusion of all other threats to women’s health makes little sense. Among the causes of death in women, breast cancer doesn’t even make the top five. It ranks 7th overall, and according to statistics from the Centers for Disease Control and Prevention, it isn’t even the number one cancer cause of death. (That would be lung cancer, by a nearly two to one margin.) Even if breast cancer is detected and appropriately treated, there is scientific consensus that up to 1 in 3 women receiving treatment gain nothing from it, because the cancer was either slow growing or the patient was destined to die of some other cause (such as a heart attack or stroke) before the cancer would have caused any symptoms.
Finally, well-intentioned cancer awareness efforts can backfire by encouraging unnecessary or unproven screening for cancers. During the Facebook campaign, I was dismayed to see some of my friends discussing how a similar strategy might be used to persuade men to get testicular and prostate screenings (brief or boxer color?) or women to get checked for ovarian cancer (you’ve got me on that one). Unfortunately, there is no consistent evidence that detecting any of these cancers with existing tests saves lives (ovarian cancer screening, in fact, has been proven to cause net harm), and doing so can and does lead to emotional or physical damage from false positive tests.
I’m all for cancer awareness when the goal is to reduce the risk of developing cancer, or to deploy proven screening tests for early-stage cancers in age and risk groups that are supported by good scientific evidence. But naive “awareness” – that is, high doses of enthusiasm combined with misinformation – may actually hurt as many people as it helps.