NCPA - National Center for Policy Analysis

Patients Enthusiastic About Screening for Cancer

January 28, 2004

There is a growing recognition among medical professionals that cancer screening is a double-edged sword. While some individuals may benefit from early detection, others may only be diagnosed and treated for cancer unnecessarily.

Despite the possibility of receiving a false positive, most people in the United States are committed to cancer screening and would overrule a physician who recommended against cancer screening, say Lisa Schwartz, et al:

  • Eighty seven percent of adults living in the U.S. believe routine cancer screening is "almost always a good idea."
  • Seventy-four percent believe that finding cancer early saves lives "most" or "all of the time" and 53 percent believes it reduces the amount of treatment needed when cancer is found.
  • Most adult females have had cancer screening; 99 percent of U.S. women aged 40 years or older reported having a Papanicoloau test (to detect cervical cancer) and 89 percent have had a mammogram.
  • Seventy-one percent of men aged 50 years or older have had a PSA -- a blood screening test for prostate cancer.
  • If cost was not a concern, some would like to be screened as frequently as every six months: 13 percent for Papanicoloau test, 16 percent for mammography and 19 percent for PSA test.

The public's enthusiasm for cancer screening and resistance to do fewer stems in large part from the messages the medical establishment itself has promulgated, say Schwarts and her colleagues. These messages hinder discussion of the prudent use of existing tests and encourage premature use of new ones. The challenge now, say the authors, is to balance messages and reduce the public's risk for over-testing and over-treatment.

Source: Lisa Schwartz, Steven Woloshin, Floyd Fowler and H. Gilbert Welch, "Enthusiasm for Cancer Screening in the United States," Journal of the American Medical Association, January 7, 2004.

For JAMA abstract


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