Whether it is a mammogram, colonoscopy or a skin cancer screening – after a certain age, we are subject to various early cancer detection screenings. Yet many of us don’t know that these screening tests are also associated with risks. This is something what Dr. Sylvia Sänger from the University Medical Center Hamburg-Eppendorf discovered in a study.
In this interview with MEDICA.de, she talks about the reasons for this lack of knowledge, further study results and the point of different early detection methods.
Dr. Sänger, in your study about early cancer detection tests you discovered that 46 percent of patients don’t feel adequately informed by their physician about the advantages and risks of screening tests. Why is that?
Sylvia Sänger: Every physician is obligated to educate his patients on examination or treatment methods – this also applies to early detection. He should introduce all options to the patient and explain their benefits and risks. Only then is it possible to ponder the purpose of a screening test for the respective patient together. This approach however, is still not practiced by all physicians.
Among other reasons, this is due to historic development. Ever since the statutory early detection programs have been introduced in 1971, the notion was "detected early- danger averted". Today we know that this is not the norm.
What’s more, we only have a limited amount of data available to properly illustrate the benefits and risks of early cancer detection. We need randomized controlled trials for this where the healthy population is randomly assigned into two groups. In one of the groups, early detection screenings are conducted over many years and none with the other group. Subsequently, you compare how many people from both groups were saved from cancer death. These types of high-quality studies are not yet available to a sufficient degree.
How can this be counteracted?
Sänger: Not only do we need better studies, but also better informative literature for physicians and patients. I would like to illustrate this with the example of mammography education. Women after the age of 50 are asked to get this type of screening test. When it comes to benefits and risks, the fact sheet from 2003 only states that the benefits outweigh the possible risks. The pamphlet was revised in 2010 to also include the stats on so-called false-positive test results. This means that a tumor might be detected that actually isn’t there at all or a woman is given the all-clear even though she has cancer. This type of information was not mentioned this way before.