Experts call for rethink of cancer screening practices

Source: Xinhua| 2017-07-26 12:52:53|Editor: Zhang Dongmiao
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SYDNEY, July 26 (Xinhua) -- Leading health experts have called for a global rethink of cancer screening processes on Wednesday, with new research suggesting current practices lead to unfavourable health outcomes for many patients.

The need to adequately ensure that the health of patients is secure still remains paramount, but researchers argue that adopting a "one size fits all" methodology is actually detrimental to many who are being screened, particularly for prostate and breast cancers.

A primary concern for experts is overdiagnosis, and it is often difficult to ascertain when a person has actually been overdiagnosed, and often patients will still undergo potentially harmful cancer treatments, Jolyn Hersch, a doctor at the University of Sydney School of Public Health told Xinhua on Wednesday.

"Cancer treatments can have a lot of important effects on people, both short term side effects, and also long term side effects," Hersch said.

"It can increase people's risk of having other health problems, it can lead to important symptoms that affect their everyday life - and apart from the actual treatment - just being diagnosed raises a lot of anxiety and affects how people feel, it can change their lives immediately."

Mental health concerns that stem from the overdiagnosis of patients is a real problem, according to Hersch, who said that they not only affect the individual going through the process, but also their families, friends, and those who care about them.

"Things like anxiety, depression, are increased in people who have cancer. They can be body image issues that come along with some of the treatments that they undergo. It can really be a life changing thing," Hersch said.

The American Society of Clinical Oncology figures in 2010 estimated the global cost of cancer was 1.16 trillion U.S. dollars, which when long term costs are added, balloons to 2.5 trillion U.S. dollars per annum.

Hersch said that the ongoing cost of medical intervention has to be factored into the debate regarding overdiagnosis.

"All of that medical intervention that people are going through takes resources away from people that might potentially need those treatments more, or other broader public health initiatives that could really have a bigger effect on helping people," Hersch said.

Another issue when considering the best way to handle overdiagnosis is the notion of autonomy, which raises the question as to the line that needs to be drawn between the patients choice of treatment, and external pressure on that decision making process.

"A patient generally should be free to make his or her own healthcare decisions. This is especially important in relation to decision making and risk warnings as this is the part of the doctor patient relationship where the patient has the most amount of power and autonomy," Julia Werren, senior law lecturer at the University of New England, told Xinhua recently.

Despite the possibility of patients "slipping through the cracks" with a more balanced approach to cancer diagnosis, Werren said that at least in the state of New South Wales, tort reform has ensured that these outcomes are far less likely to result in litigation against doctors should a diagnosis be missed.

"It is much more difficult for a patient to have a viable action against a doctor in negligence. Aside from a tortious or negligent action, there are other mechanisms which can be used by patients, such as the systems relating to health care complaints," Werren said.

Despite the implications for doctors who attempt to avoid overdiagnosis - and the need for further education of the public in terms of screening - Hersch, and the other researchers, believe that there can be a balance struck between all parties to deal with what drives this prevalent issue.

"There's a lot of drivers, and I think most of what clinicians do, is really trying to do what they believe is best for the patients," Hersch said.

"And also, patients believing that finding things early and treating them early is the best thing to do."