Value of Many Preventive Measures Unproven
March 19, 2003
Doctors and patients have come to think that catching a disease early and treating it aggressively can make you live longer. The problem is there's little evidence that early intervention is beneficial beyond a few diseases and conditions.
- Early intervention for high blood pressure reduced strokes by one-third and heart disease by 20 percent.
- Identifying diabetes early reduces cardiovascular disease, kidney and neurological damage and blindness.
- Early intervention can prevent an abdominal aneurysm from rupturing.
Yet, there are many other instances where the efficacy of preventive measures is uncertain. A case in point is the prostate cancer (PSA) blood test.
- A recent study found men in Seattle were over 5 times as likely to obtain one (and have the resulting surgery if the PSA test is positive) than men in Connecticut.
- Yet the death rate for both areas was the same despite far more aggressive treatment in Seattle.
Angioplasty and carotid endarterectomy are two other common procedures for which many procedures may not be efficacious. Critics often suggest we should do more to treat the underlying causes of chronic conditions -- for instance, by adopting healthy lifestyles to control high blood pressure and high cholesterol -- rather than wait and use surgery to correct problems.
Source: Shannon Brownlee, "The Perils of Prevention," New York Times Magazine, March 16, 2003.
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