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Cancer screening in theory and in practice
Otis W Brawley1, Barnett S Kramer
1Georgia Cancer Center, Glenn Memorial Bldg, 69 Jesse Hill Jr Drive, Atlanta, GA 30303, USA. otis_brawley@emoryhealthcare.org
Summary
Cancer screening tests offer benefits but carry inherent harms, challenging the common perception of safety. Understanding the balance between potential benefits and harms is crucial for effective cancer screening strategies.
Area of Science:
- Oncology
- Epidemiology
- Clinical Medicine
Background:
- Technological advancements have increased the availability of cancer screening tests.
- Cancer screening is widely promoted, but its complexities and potential harms are often oversimplified.
- Current guidelines may not fully address the risks associated with cancer screening.
Purpose of the Study:
- To clarify the principles of cancer screening.
- To differentiate between screening and diagnostic tests.
- To highlight the potential harms associated with cancer screening.
Main Methods:
- Review of established cancer screening principles.
- Analysis of the distinction between screening and diagnostic testing contexts.
- Examination of the benefit-harm balance in cancer screening.
Main Results:
- Every cancer screening test carries potential harms.
- Screening tests should be used when benefits clearly outweigh harms.
- The context of test application determines if it's screening or diagnostic.
Conclusions:
- Cancer screening is complex and involves risks, contrary to public perception.
- Epidemiological principles are essential for understanding cancer screening.
- Clinicians must be aware of the harms and benefits of screening tests for informed decision-making.