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Cancer. #Screening. #overdiagnosis

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Painless cancer detection could become routine thanks to 'liquid biopsies' Researchers are developing tests that could make cancer detection so painless that it becomes part of routine check-ups, experts said, as new developments in such “liquid biopsy” technology were presented at the world’s largest cancer conference in Chicago this weekend.

Painless cancer detection could become routine thanks to 'liquid biopsies'

Collecting tumor tissue through biopsies is considered the gold standard for diagnosing and treating cancer. However, necessary surgery is often invasive and sometimes unsuccessful. That has fueled interest in technology that uses blood samples to examine bits of DNA shed into the bloodstream by tumors. The hope, researchers say, is to save patients the pain of surgery, monitor tumor growth to tailor treatment, and ultimately to save lives. “But that’s a theoretical figure. Like all cells, cancerous cells shed DNA as they die. Part of the challenge in developing such tests is scale. Pieces of genetic material, called “cell-free DNA”, are found in blood plasma. Another abstract presented at ASCO took the opposite approach. Systematic review with meta-analysis: the comparative effectiveness of aspirin vs. screening for colorectal cancer prevention.

Conclusions in systematic reviews of mammography for breast cancer screening and associations with review design and author characteristics. Selection of reviews Review articles were included in the analysis if they met all four of the following inclusion criteria: (a) the reviewers specified a search criteria and the databases in which the search was conducted; (b) the review was focused on mammography for breast cancer screening; (c) at least two primary studies addressing the harms or benefits of mammography were cited; and (d) the reviewers made conclusions about the harms or benefits of mammography for breast cancer screening in relation to the evidence.

Conclusions in systematic reviews of mammography for breast cancer screening and associations with review design and author characteristics

Outcomes related to benefits included breast cancer survival (mortality reduction), and cost-effectiveness of screening for quality-of-life. Outcomes related to harms included over-diagnosis, false positives, unnecessary treatments, radiation cancers, anxiety or worry, and pain or discomfort. Implementation of Lung Cancer Screening in the Veterans Health Administration. Cancer Blood Tests Could Lead to Over-Diagnosis. Can your own biology mislead you about your cancer risk?

Cancer Blood Tests Could Lead to Over-Diagnosis

For all practical purposes, yes, according to a group of experts at a Wednesday panel during Fortune's second annual Brainstorm Health conference in San Diego. The session centered on the hot new technology of "liquid biopsies"—a fancy term for blood tests that can potentially supplant traditional, surgery-based tissue biopsies by sensing tell-tale biological markers and tiny little DNA fragments that circulate through the body. As panel moderator and Fortune editor in chief Clifton Leaf noted, the technology has gained enough interest and progressed enough in recent years that one of the biggest cancer conferences in the world featured more than 130 papers and studies on it last month. Click here to subscribe to Brainstorm Health Daily, our brand new newsletter about health innovations.

Why we need a new war on cancer: Over-treating and over-screening is doing patients more harm than good. The issue: Advances in screening and diagnosis are sending some cancer patients down aggressive treatment paths that they shouldn’t be on.

Why we need a new war on cancer: Over-treating and over-screening is doing patients more harm than good

The solution: A new war on cancer and a rethinking of resources. First instalment in an ongoing series. Medscape Access. Extended mortality results for prostate cancer screening in the PLCO trial with median follow-up of 15 years. Human Papillomavirus Assays and Cytology in Primary Cervical Screening of Women Aged 30 Years and Above. Overdiagnosis of gastric cancer by endoscopic screening. Why cancer screening has never been shown to “save lives”—and what we can do about it. Vinay Prasad, assistant professor1, Jeanne Lenzer, journalist2, David H Newman, professor3Author affiliationsCorrespondence to: V Prasad prasad@ohsu.eduAccepted 29 October 2015.

Why cancer screening has never been shown to “save lives”—and what we can do about it

Harms of cervical cancer screening in the United States and the Netherlands - Habbema - 2017 - International Journal of Cancer. We studied harms related to cervical cancer screening and management of screen-positive women in the United States (US) and the Netherlands.

Harms of cervical cancer screening in the United States and the Netherlands - Habbema - 2017 - International Journal of Cancer

We utilized data from four US integrated health care systems (SEARCH), the US National Health Interview Survey, New Mexico state, the Netherlands national histopathology registry, and included studies on adverse health effects of cervical screening. We compared the number of Papanicolaou (Pap) smear tests, abnormal test results, punch biopsies, treatments, health problems (anxiety, pain, bleeding and discharge) and preterm births associated with excisional treatments. Results were age-standardized to the 2007 US population. Based on SEARCH, an estimated 36 million Pap tests were performed in 2007 for 91 million US women aged 21–65 years, leading to 2.3 million abnormal Pap tests, 1.5 million punch biopsies, 0.3 million treatments for precancerous lesions, 5 thousand preterm births and over 8 million health problems. Principles of Cancer Screening: Lessons from History and Study Design Issues.

Canadian Task Force on Preventive Health Care. Meet John and Mary.

Canadian Task Force on Preventive Health Care

They’re busy juggling their life, family, and careers. Just like them, you might find it confusing when the subject of cancer screening comes up. Although both are symptom-free, John may wonder whether to get screened for prostate cancer, and Mary might have a conversation with her doctor about breast cancer screening. Often, people like John and Mary assume that all cases of a particular type of cancer will progress in the same way, that being diagnosed with breast cancer or prostate cancer automatically means suffering severe illness and this perspective, screening sounds like it’s always beneficial because it will catch things early and treatment can begin immediately.

In reality, screening and early diagnosis don’t necessarily lead to a better two people develop the same form of cancer and succumb to their illnesses at the same time, one diagnosed early through screening, the second diagnosed only after having symptoms. To screen or not to screen. Figure 1 Hypotheses underlying screening according to the individual (A) and population (B) perspectives.

To screen or not to screen

FN = false-negative; FP = false-positive; TN = true-negative; TP = true-positive. Screening for Skin Cancer: US Preventive Services Task Force Recommendation Statement. Medscape: Medscape Access. Watchful Waiting: When Treatment Can Wait. In today's fast-paced world, waiting — whether it's at the doctor's office, in line at the grocery store or for an Internet connection — is rarely considered a good thing.

Watchful Waiting: When Treatment Can Wait

But when it comes to certain medical conditions, delaying treatment while regularly monitoring the progress of disease — a strategy doctors refer to as "watchful waiting," active surveillance or expectant management — may benefit some patients more than a rush to pharmaceutical or surgical options. Patients want to know what they're waiting for, says urologic oncologist E. Addressing overdiagnosis and overtreatment in cancer. When screening is bad for a woman's health. If you haven't gotten this message already, you should heed it now: The benefits of screening for breast cancer are limited.

When screening is bad for a woman's health

We should be doing fewer screening mammograms, not more. The data that support this conclusion come from studying the effects of mammography across time and place. A couple of years ago an Oregon colleague and I reported on the effect across time. Unintended consequences of expensive cancer therapeutics—the pursuit of marginal indications and a me-too mentality that stifles innovation and cre... ‘Catch it early, save a life and save a breast’: this misleading mantra of mammography J R Soc Med 2015 Baum 338 9. Discussions of Life Expectancy and Changes in Illness Understanding in Patients With Advanced Cancer. © 2016 by American Society of Clinical Oncology + Author Affiliations Corresponding author: Holly G.

Prigerson, PhD, 525 E 68th St, 1404 Baker Pavilion, New York Presbyterian Hospital, New York, NY 10065; e-mail: Presented in abstract form at the 51st Annual Meeting of the American Society of Clinical Oncology (ASCO), Chicago, IL, May 29-June 2, 2015, and at the ASCO Palliative Care in Oncology Symposium, Boston, MA, October 9-10, 2015. Abstract. Cancer patients keep getting aggressive end-of-life treatment. Cancer patients and their doctors do not want to give up. Despite efforts by the professional association of oncologists to persuade physicians to treat cancer patients less aggressively at the end of their lives, that is not happening, researchers reported on Monday. The study, presented at the annual meeting of the American Society of Clinical Oncology in Chicago, is the first to examine aggressive end-of-life care in cancer patients younger than 65. article continues after advertisement.

The Psychological Effects of Lung Cancer Screening on Heavy Smokers:  Another Reason for Concern. Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial. Annals Graphic Medicine: Living on Benefits: How Cancer Screening Is Portrayed in the U.K. National PressLiving on Benefits. Disclosures: Disclosures can be viewed at MsNum=G15-0019.

Author and Illustrator Information: Dr. Population-based screening for cancer: hope and hype. Presentation of Benefits and Harms in US Cancer Screening and Prevention Guidelines: Systematic Review. Background: Cancer prevention and screening guidelines are ideally suited to the task of providing high-quality benefit-harm information that informs clinical practice. We systematically examined how US guidelines present benefits and harms for recommended cancer prevention and screening interventions.

Methods: We included cancer screening and prevention recommendations from: 1) the United States Preventive Services Task Force, 2) the American Cancer Society, 3) the American College of Physicians, 4) the National Comprehensive Cancer Network, and 5) other US guidelines within the National Guidelines Clearinghouse. Searches took place November 20, 2013, and January 1, 2014, and updates were reviewed through July 1, 2015. Task force recommends against colonoscopy for routine colorectal cancer screening.

TORONTO — Colonoscopy should not be used for routine screening of colorectal cancer in patients with no symptoms or family history of the disease, the Canadian Task Force on Preventive Health Care advises in updated guidelines issued Monday. Instead, the task force strongly recommends that low-risk patients aged 50 to 74 be screened for colorectal cancer using stool-based testing every two years or sigmoidoscopy every 10 years. Sigmoidoscopy is a procedure in which a flexible scope allows the doctor to view the lower portion of the colon and rectum, not the entire colon as is the case with colonoscopy.

In Cancer Screening, Why Not tell the truth? Why cancer screening has never been shown to “save lives”—and what we can do about it. Overdiagnosis and Overtreatment in Cancer:  An Opportunity for Improvement. Over the past 30 years, awareness and screening have led to an emphasis on early diagnosis of cancer. Although the goals of these efforts were to reduce the rate of late-stage disease and decrease cancer mortality, secular trends and clinical trials suggest that these goals have not been met; national data demonstrate significant increases in early-stage disease, without a proportional decline in later-stage disease. What has emerged has been an appreciation of the complexity of the pathologic condition called cancer.

The word “cancer” often invokes the specter of an inexorably lethal process; however, cancers are heterogeneous and can follow multiple paths, not all of which progress to metastases and death, and include indolent disease that causes no harm during the patient’s lifetime. Better biology alone can explain better outcomes. Over-diagnosis of thyroid cancer in Korea – Lown Institute. February 13, 2015 By Sang Won Shin, MD For the Lown Institute In 1997, in the small town of Young-kwang in the southwest, a doctor opened a private internal medicine clinic. For some reason, he decided to provide patients ultrasonography screening for thyroid cancer. It did not take long for him to be admired for saving many lives by detecting early thyroid cancers. The news rapidly spread to the nearby towns and cities. Suddenly the incidence of thyroid cancer in Jeon-nam Province, where Young-kwang is located, drastically soared. Another turning point came when the Korean government initiated an ambitious nationwide cancer screening program, targeting stomach, liver, breast and colon cancers.

The Use of Superlatives in Cancer Research. This investigation of recent news coverage of cancer research found that although most new cancer drugs offer only modest benefits, they are often described in the news media with superlatives, such as “revolutionary” and “game changer,” that may be unwarranted. The language used in oncology practice and research may elicit important connotations.1 Whereas most new cancer drugs afford modest benefits,2 approved drugs or those in development may be heralded as “game changers” or “breakthroughs” in the lay press. We should look less hard for cancer. Screening for Occult Cancer in Unprovoked Venous Thromboembolism. Does screening for disease save lives in asymptomatic adults? Systematic review of meta-analyses and randomized trials. Screening for Disease Where No Symptoms Exist. Targeted Cancer Screening in Average-Risk Individuals. The Oversimplification of Early Detection. Quantifying and monitoring overdiagnosis in cancer screening: a systematic review of methods.

Q&A: What is Cancer Overdiagnosis? Should I Get Tested for Cancer? Screening for Occult Cancer in Unprovoked Venous Thromboembolism. Cancer Screening. Regular self-examination or clinical examination for early detection of breast cancer. Accepting Breast Cancer Overdiagnosis. Breast Cancer Screening in Denmark. Why mammograms haven’t cut cancer deaths, explained in 500 words. Surveillance Mammography in Older Patients With Breast Cancer—Can We Ever Stop? Screening mammography leads to overdiagnosis of small breast tumors.

'Stage 0' breast cancer surgically overtreated in U.S. - Health. Double mastectomy after breast cancer is pointless for most women, experts find. Mammography Screening: What Should the Global Population Know?: Breast Cancer Deadline 2020. Breast Cancer Screening, Incidence, and Mortality Across US Counties. Benefits and harms of mammography screening. Why Doctors Are Rethinking Breast-Cancer Treatment. Preoperative Breast Magnetic Resonance Imaging and Contralateral Breast Cancer Occurrence Among Older Women With Breast Cancer. Absolute Effect of Prostate Cancer Screening: Balance of benefits and harms by center within the European Randomized Study of Prostate Cancer Screeni... Prevalence of Nonrecommended Screening for Prostate Cancer and Breast Cancer in the United States:  A Nationwide Survey Analysis.

Prostate Cancer Diagnosis and Treatment After the Introduction of Prostate-Specific Antigen Screening: 1986–2005. Are patients being informed about prostate cancer screening risks? Early Prostate Cancer Cases Fall Along With Screening. Screening for lung cancer: A systematic review and meta-analysis. Selecting the Best Candidates for Lung Cancer Screening. CHEST: Management of Pulmonary Nodules. Cancer scans overdone - The National - CBC Player. Needless breast cancer imaging common in Ontario, study finds. Nomenclature Revision for Encapsulated Follicular Variant of Papillary Thyroid Carcinoma:  A Paradigm Shift to Reduce Overtreatment of Indolent Tumors.